Corticotropin shares the same profile of indica- tions as systemic glucocorticoids: polyarticular flares in which NSAIDs are not effective or contraindicated. However, corticotropin is more costly compared with generic glucocorticoids and not as widely available. Its mechanism of action seems to be through stimulation of endog- enous adrenal hormones (63, PDF); however, direct anti- inflammatory effects at the affected site also have been postulated (64). Corticotropin is available for subcutaneous or intramuscular adminis- tration, and a single dose of 40 IU is rapid, efficient, and well tolerated, even in patients using moderate doses of oral glucocorticoids (65, 66, 67) Adverse effects include mild hypokalemia, fluid retention, hyperglycemia, and the development of rebound arthritis; the latter is controlled by administration of prophylactic low-dose colchicine (if possible).Source: Gaffo and Saag. Management of hyperuricemia and gout in CKD. Am J Kidney Dis (2008) vol. 52 (5) pp. 994-1009
Anybody doing this?
