Calcium pyrophosphate deposition (CPPD) disease does not always cause acute episodic attacks. In a clinically distinct subset of patients, it manifests as a persistent, chronic inflammatory arthropathy that requires a sustained therapeutic approach.
A subset of patients with CPP arthritis presents with chronic joint inflammation that can be mistaken for rheumatoid arthritis. Chronic CPP crystal arthritis is characterised as a chronic inflammatory oligoarthritis or polyarthritis — a pattern that demands treatment directed at ongoing joint inflammation rather than episodic flare management alone.
Evidence-based guidance supports use of an oral antimalarial agent as a core therapy in this chronic inflammatory pattern, with the option to combine it with additional anti-inflammatory agents in appropriate patients. The precise dosing schedule, titration strategy, and full set of combination options are detailed in the complete protocol.
Full algorithm available in the structured regimen below.
DOI: 10.3389/fmed.2024.1327715
A subset of patients with CPP arthritis may present with symptoms of chronic joint inflammation that can be mistaken for RA.
Chronic CPP crystal arthritis, on the other hand, is a chronic inflammatory oligoarthritis or polyarthritis.
The dosage of HCQ was started at 100 mg/day and was increased every month to a maximum of 400 mg/day for non-responders.
However, EULAR recommendations include HCQ for chronic inflammatory arthritis with CPPD.
A response rate (as defined by at least a 30% reduction in the number of swollen and tender joints) was seen in 76% of the treatment group compared with 32% in the placebo group.
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