A randomized trial for the treatment of gout by epwhoseine and autumn daffodils was compared.

This article is from the NEJM journal watch managing acute gout: a randomized trial of Allan S. Brett, MD, naproxen and colchicine are equally effective.oral therapeutic drugs (i.e., colchicine, NSAID, or steroids) for patients with acute gout attacks are usually individualized based on potential side effects, contraindications, costs, and patient preferences.in the UK trial, 399 patients with acute gout were randomly assigned to either the naproxen group (initial dose 750 mg; followed by 250 mg tid for 1 week) or the colchicine group (0.5 mg tid for 4 days).the patients included in this study had no significant contraindications for the two drugs; patients with glomerular filtration rate < 30 ml / min were excluded.70% of patients had first metatarsophalangeal joint involvement (with or without other lower limb joint involvement).both treatments were effective.pain relief was similar in naproxen group and colchicine group, both groups achieved relief within 7 days and at the first month.the incidence of diarrhea in colchicine group was higher than that in naproxen group.comments I plan to apply the useful information provided by this trial to clinical practice.this study confirmed the efficacy of short-term colchicine three times a day for acute gout attack; colchicine with a smaller dose is usually ineffective, but with a larger dose, the tolerance is poor.this trial also confirmed the efficacy of naproxen, a nonsteroidal anti-inflammatory drug that is over-the-counter in the United States and is much cheaper than colchicine.oral prednisone can be reserved for patients who have contraindications for both drugs.finally, the long-term treatment of gout was not explored in this study, which may require the use of uric acid reducing therapy and the daily low-dose colchicine or NSAID prophylactic medication for a period of time.Roddy e et al. Open label random practical trial (contact) comparing naproxen and low dose colicine for the treatment of out of flowers in primary care. Ann Rheum dis 2020 Feb; NEJM journal watch is published by NEJM group. Famous international doctors are invited to comment on important papers in medical field to help doctors understand and apply the latest progress."NEJM medical frontier" translated several articles every week, published on app and official website, and 2-3 selected articles were published on wechat.copyright information this article is translated, compiled or invited by the editorial department of NEJM medical frontier.for the translation and writing of articles originated from the English products of NEJM group, the original English version shall prevail. the full text of the Chinese translation and the charts included are exclusively authorized by the NEJM group of the Massachusetts Medical Association. for reprint, please contact nejmqianyan@nejmqianyan.cn 。 unauthorized translation is an infringement, and the copyright owner reserves the right to investigate the legal liability.