Patient selection: acute gouty attack treated with monotherapy within 24 hours of onset
Criteria for an adequate response to therapy – both of the following:
(1) There is an improvement in the pain score in the first 24 hours >= 20%.
(2) There is an improvement in the pain score after 24 hours >= 50%.
improvement in the pain score =
= ((initial pain score) – (followup pain score)) / (initial pain score) * 100%
where:
• The pain score is based on a 10 cm VAS.
A patient with an inadequate response to therapy may be managed by one of the following:
(1) switch to an alternative monotherapy
(2) addition of a second agent to the original monotherapy
(3) switch to a novel therapy if standard therapies fail to give an adequate response
Limitations:
• A low initial VAS pain score may not change as dramatically as a higher one to therapy.
