Most of the drugs prescribed to treat acute gouty attacks were used before the introduction of modern clinical trials. Thus, there are few well-designed studies available to evaluate these drugs. Nevertheless, worldwide clinical experience supports the use of most nonsteroidal anti-inflammatory drugs (NSAIDs), @entity3812 and @entity288 in the treatment of @entity697 . @entity3812 has been widely used but @entity137 , especially gastrointestinal adverse effects, are a major concern. Therapeutic regimens involving hourly or 2-hourly administration were based on the short initial half-life of @entity3812 in plasma. Other therapy schedules, such as early 8-hourly administration, may be equally effective and have fewer adverse effects. Unfortunately, comparative studies to investigate this have not been performed. @entity3812 should not be prescribed to @entity1 with either severe @entity177 or combined @entity177 . Doses should be halved in @entity1 with moderate @entity8 . NSAIDs are the most widely prescribed drugs in the treatment of @entity697 . Few comparative data are available, but any of the most potent NSAIDs are probably useful in the control of @entity158 and inflammatory signs of @entity3811 . Pharmacokinetic properties should be taken into account when selecting an NSAID for the treatment of gout, as rapid absorption and a short half-life may help to avoid accumulation in @entity1 with @entity8 . Comorbidities should always be kept in mind when prescribing NSAIDs. @entity1 with previous or recent @entity360 , those receiving anticoagulant therapy or with @entity548 diathesis, and those with @entity177 are at risk of developing severe adverse effects from NSAID administration. @entity288 are probably a reasonable choice for @entity1 in whom @entity3812 and NSAIDs may be hazardous or for those with a history of previous intolerance to these drugs. Few trials using @entity229 , @entity617 or @entity2995 are available, and dosages are prescribed following empirical data. Corticotropin has also been used to treat @entity697 . Although it has been proven to be as effective as other @entity288 or @entity3352 , the need for multiple doses, parenteral administration and the high cost are major limitations for its use. Currently, the choice of a drug for the treatment of @entity697 will depend on the balance between its efficacy and the potential adverse effects in a particular @entity1 .

Optimisation of the treatment of XXXX .

@entity1 :: ('9606', 'Species') :: ['patient', 'Patients', 'patients'] @entity8 :: ('MESH:D007674', 'Disease') :: ['subclinical renal function impairment', 'renal function impairment'] @entity697 :: ('MESH:D000208', 'Disease') :: ['acute gout'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity2995 :: ('MESH:D014222', 'Chemical') :: ['triamcinolone acetonide'] @entity548 :: ('MESH:D006470', 'Disease') :: ['haemorrhage'] @entity3811 :: ('MESH:D015210', 'Disease') :: ['acute gouty arthritis'] @entity229 :: ('MESH:D011241', 'Chemical') :: ['prednisone'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal insufficiency', 'hepatic-renal insufficiency'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity3812 :: ('MESH:D003078', 'Chemical') :: ['colchicine', 'Colchicine'] @entity3352 :: ('MESH:D007213', 'Chemical') :: ['indomethacin'] @entity360 :: ('MESH:D006471', 'Disease') :: ['gastrointestinal bleeding'] @entity617 :: ('MESH:D011239', 'Chemical') :: ['prednisolone'] @entity288 :: ('MESH:D000305', 'Chemical') :: ['corticosteroids', 'Corticosteroids']
@entity697 :: (MESH:D000208,Disease) :: ['acute gout']
