Pain Management in Acute Gout: NSAIDs or COX-2 Inhibitors?

February 25, 2021
Veronica Hackethal, MD

A recent meta-analysis assessed comparative clinical efficacy of NSAIDs and COX-2 inhibitors. Try these 7 questions on the findings - does your clinical experience match?

A 2020 meta-analysis published in BMJ Open assessed the comparative clinical efficacy of traditional non-selective NSAIDs and selective COX-2 inhibitors in patients with acute gout.

The main outcome measures included were mean change in pain Visual Analogue Scale score and 5-point Likert scale score on days 2–8. All of the following questions and answers are based on findings from this meta-analysis.

Do the analysis results match your experience in clinical practice?

Note: the meta-analysis did not include naproxen for comparisons, due to a lack of clinical trials. The analysis also did not include comparison to colchicine or corticosteroids.


1. Which of the following offers a clear advantage in terms of pain scores in acute gout?

A. Etoricoxib

B. Celecoxib

C. Meloxicam

D. Ibuprofen