Patients with calcium pyrophosphate deposition disease (CPPD) who experience three or more acute CPP crystal arthritis attacks represent a group in whom prophylactic therapy is warranted to reduce flare frequency. When the initial prophylactic approach does not achieve an adequate reduction in attacks, escalation to a next-line strategy is indicated.
Colchicine was used as the first-line prophylactic therapy, with the primary goal of reducing the number of acute CPP crystal arthritis flares. When colchicine alone does not provide an adequate response toward that goal, this protocol describes the next step in management.
The next-line strategy involves a low-dose NSAID — considered either as an addition to, or as a replacement for, the prior colchicine regimen. The complete protocol — including specific selection criteria, sequencing, and the full decision algorithm — is available via the link below.
DOI: 10.3389/fmed.2024.1327715