Calcium pyrophosphate crystal deposition: 2025 update to recent epidemiological findings

Our objective is to propose an expert opinion focusing on most important and recent developments in calcium pyrophosphate deposition (CPPD) epidemiology. We highlight recent findings published in the past 18 months and their potential implications for research and patient care.

We discuss new understanding of CPPD prevalence through advances in imaging modalities, advances in synovial fluid analyses (SFA), updates on disease phenotypes, and potential sources of misdiagnosis of CPPD. We present recent data regarding extra-articular associations of CPPD, particularly cardiovascular events and osteoporotic fractures. We discuss new therapeutic options. We identify barriers to improving research in CPPD, and tools currently available to overcome certain pitfalls.

Improved knowledge in the epidemiology of asymptomatic CPPD and symptomatic CPPD disease is crucial to improving recognition of this still underdiagnosed disease, and to understanding patient phenotypes and their outcomes. Future research will require prospective designs to establish the prevalence of CPPD disease phenotypes and to provide more precise data according to each phenotype, both in terms of epidemiological findings and treatment responses, to develop personalized medicine.