Corticotropin for acute management of gout

OBJECTIVE: To evaluate safety and efficacy of corticotropin for acute gout. DATA SOURCES: Clinical literature was accessed through MEDLINE (1966 - August 2000). Key search terms included gout, ACTH, adrenocorticotropic hormone, and corticotropin. DATA SYNTHESIS: Joint pain and local signs of inflammation characterize gout. Acutely, colchicine and nonsteroidal antiinflammatory drugs (NSAIDs) are first-line therapy. Adverse effects or concomitant diseases limit therapy and necessitate alternative options. An evaluation of studies involving corticotropin was conducted. CONCLUSIONS: Corticotropin alone or in combination with colchicine was more rapidly effective and associated with fewer adverse effects than indomethacin. This regimen may be considered an alternative, especially for patients with medical problems in which other regimens are contraindicated.