How well do non-steroidal anti-inflammatory drugs (NSAIDs) work to treat gout and is one better than the other?

What is gout and how can it be treated?
Gout is a type of arthritis in which there is a build up of crystals from uric acid in the joints of the body.  In gout, the body either makes too much uric acid or it is not able to flush out excess uric acid from the body fast enough.  When it builds up, the uric acid forms into crystals and deposits in joints (especially in the big toe).  It can also deposit under the skin and in the kidneys.  In the joint, the deposits can cause pain, swelling and tenderness.  An attack of gout may occur suddenly and go away on its own after 7 to 10 days or the pain and swelling can come on slowly and last for long periods. Non-steroidal anti-inflammatory drugs (NSAIDs), such as indomethacin, naproxen, etodolac or etoricoxib, are often used to decrease the pain and swelling.  In people who cannot take NSAIDs because of side effects or when NSAIDs are not working, there are other treatments such as corticosteroids or colchicine

How well did NSAIDs work?
A study of people who did not receive treatment for gout showed that gout will not likely improve before 7 days without using NSAIDs. 

Seven studies that compared different NSAIDs to each other all showed that people improved when receiving NSAIDs.  But the studies have not shown which NSAID works better.

What side effects occurred with NSAIDs?
Side effects that occurred were stomach and intestinal problems, such as ulcers and bleeding (3 out of 100 people had these side effects), vomiting, headache, dizziness and sleepiness.  NSAIDs may not be safe in people with kidney disease, ulcers, high blood pressure, bleeding problems and heart failure.

Based on Schumacher R, Schlesinger N, Baker D, Ottawa Methods Group. Gout.  In Evidence-based Rheumatology, London:  BMJ books, 2003 (in press).