Opioid in the pain management of acute gout arthritis: friend or foe?

Abstract

Intense and severe pain is the most common symptom of acute gout arthritis (GA) flare. A recent study revealed that opioids were commonly prescribed for 28% of acute GA flare cases. This paper aims to explain current evidence on opioid use in managing acute gout. This literature review was constructed based on a literature search on PubMed and Google Scholar in June 2022. We included all relevant studies, cohorts, and randomized controlled trial articles published in the last ten years. Meanwhile, pre-print or nonEnglish articles were excluded. The evidence regarding opioid use for acute gout pain was rare. No guidelines recommend opioids as an initial analgesic choice in managing pain for acute gout. Opioids are indicated in acute gout patients with severe kidney dysfunction if oral and intra-articular corticosteroids are ineffective in reducing pain. Opioids should be the last choice in selected cases of acute gout.