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Calcium pyrophosphate deposition (CPPD) disease - Treatment options.

John Stack1, Geraldine McCarthy1

  • 1Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland; University College Dublin, Ireland.

Best Practice & Research. Clinical Rheumatology
|November 10, 2021
PubMed
Summary

Calcium pyrophosphate crystal deposition (CPPD) is a common arthritis lacking disease-modifying treatments. Current therapies manage inflammation, but future research aims for crystal-targeted approaches to modify disease progression.

Keywords:
AnakinraCalcium pyrophosphate deposition (CPPD) diseaseColchicineCorticosteroidHydroxychloroquineManagementMethotrexateNSAIDsTocilizumabTreatment

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Area of Science:

  • Rheumatology
  • Crystal Arthropathies
  • Inflammatory Arthritis

Background:

  • Calcium pyrophosphate crystal deposition (CPPD) is a prevalent inflammatory arthritis.
  • Unlike gout, CPPD lacks disease-modifying therapies targeting crystal deposition.
  • Evidence-based treatment guidelines for CPPD are currently insufficient.

Purpose of the Study:

  • To review current anti-inflammatory treatment options for CPPD.
  • To discuss emerging crystal-targeted therapeutic strategies for CPPD.
  • To highlight advancements in CPPD classification and research facilitation.

Main Methods:

  • Literature review of existing anti-inflammatory treatments for CPPD.
  • Discussion of potential future therapies, including crystal-targeting agents.
  • Analysis of recent developments in CPPD classification criteria and research infrastructure.

Main Results:

  • Current CPPD treatments (NSAIDs, colchicine, corticosteroids) manage symptoms but do not alter disease course.
  • Anakinra and tocilizumab show potential for refractory CPPD cases.
  • Ex-vivo studies suggest nucleoside analogues and phosphocitrate may attenuate cartilage calcification.

Conclusions:

  • Effective disease-modifying therapies for CPPD are needed.
  • Future research, aided by new classification criteria, will focus on crystal-targeted treatments.
  • Improved understanding and therapeutic strategies are anticipated for CPPD management.