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Naproxen or low-dose colchicine for gout flares in primary care? Response to: ‘Open-label randomised pragmatic trial (CONTACT) comparing naproxen and low-dose colchicine for the treatment of gout flares in primary care’ by Parperis et al
  1. Edward Roddy1,
  2. Christian D Mallen1,2
  3. on behalf of the CONTACT trial authors
  1. 1School of Primary, Community and Social Care, Keele University, Keele, UK
  2. 2Haywood Academic Rheumatology Centre, Midland Partnership NHS Foundation Trust, Stoke-on-Trent, UK
  1. Correspondence to Dr Edward Roddy, School of Primary, Community and Social Care, Keele University, Keele, ST5 5BG, UK; e.roddy{at}

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We concluded that naproxen should be considered as first-line treatment for gout flares in primary care based on there being no difference between naproxen and colchicine in pain intensity (the primary outcome), more analgesic use and self-reported side-effects in the colchicine group, and evidence that naproxen was cost-effective.1 We note the Bayesian meta-analysis by Bally et al in which all non-steroidal anti-inflammatory drugs (NSAIDs), including naproxen, were associated with increased risk of myocardial infarction.2 However, this review was limited by including only studies undertaken in healthcare databases risking bias due to residual confounding …

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