Comparison of adrenocorticotropic hormone and triamcinolone acetonide in the treatment of acute gouty arthritis

J Rheumatol. 1994 Jul;21(7):1325-7.


Objective: To determine the best alternative therapy for acute gouty arthritis when nonsteroidal antiinflammatory drugs or colchicine are contraindicated.

Methods: Thirty-one patients with crystal proven gout presenting with an acute attack of < 5 days' duration were treated prospectively with either a single intramuscular injection of adrenocorticotropic hormone (ACTH) 40 IU or triamcinolone acetonide 60 mg. The patients were followed for 30 days.

Results: Resolution of all symptoms occurred at an average of 8 days for both groups. No adverse reactions were noted in either group; however, there were 11 reinjections in the ACTH group and 5 reinjections in the triamcinolone acetonide group. Two patients from the ACTH arm were transferred to the triamcinolone acetonide arm because of rebound arthritis.

Conclusion: Although recent studies of ACTH and triamcinolone acetonide have demonstrated efficacy and safety comparable to indomethacin, in a direct comparison of the 2 at the doses used, triamcinolone acetonide resulted in fewer rebound attacks and treatment failures than ACTH and required fewer reinjections.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Acute Disease
  • Adrenocorticotropic Hormone / administration & dosage
  • Adrenocorticotropic Hormone / therapeutic use*
  • Aged
  • Arthritis, Gouty / drug therapy*
  • Humans
  • Injections, Intramuscular
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • Triamcinolone Acetonide / administration & dosage
  • Triamcinolone Acetonide / therapeutic use*


  • Adrenocorticotropic Hormone
  • Triamcinolone Acetonide