Drug therapy for CPPD in real clinical practice

According to the recommendations of the ELUAR expert committee, the choice of drug therapy for calcium pyrophosphate deposition disease (CPPD) is based on the clinical presentation (phenotype) of the disease. However, it is unknown whether this approach is implemented in real clinical practice. The aim of the study was to analyze the frequency of use of drugs prescribed for the treatment of CPPD in various phenotypes of the disease. Materials and methods. A total of 266 patients with CPPD over 18 years of age with clinical symptoms were examined. These patients were divided into phenotypes: recurrent acute arthritis, chronic arthritis, and osteoarthritis (OA) with calcium pyrophosphate (CPP) crystals. The frequency of prescription of colchicine, methotrexate, hydroxychloroquine, glucocorticoids (GCs), and nonsteroidal anti-inflammatory drugs (NSAIDs) was compared. Results. Based on phenotyping results, the group of patients with acute arthritis consisted of 40 patients (15 %), chronic arthritis – 157 (59 %), and OA with PFK crystals – 69 (26 %). The frequency of medications used to treat CPPD in all study participants (n=266): 207 patients (77.8 %) received NSAIDs, 97 (36.5 %) colchicine, 46 (17.3 %) hydroxychloroquine, 60 (22.6 %) methotrexate, and 34 (12.8 %) GCs. In acute arthritis, 30 patients (75 %) received NSAIDs, 5 (12.5 %) GCs, 17 (42.5 %) colchicine, 4 (10 %) hydroxychloroquine, and 8 (20 %) methotrexate. Patients with chronic arthritis: 123 (78.3 %) NSAIDs, 21 (13.4 %) – GCs, 58 (36.9 %) – colchicine, 29 (18.5 %) – hydroxychloroquine, 40 (25.5 %) – methotrexate. Patients with OA with CPP crystals: 54 (78.3 %) – NSAIDs, 8 (11.6 %) – GCs, 22 (31.9 %) – colchicine, 13 (18.8 %) – hydroxychloroquine, 12 (17.4 %) – methotrexate. Conclusions. The most commonly used medications for CPPD are NSAIDs and colchicine, with no significant differences in the frequency of prescription of individual medications across different disease phenotypes. The use of low-dose colchicine in CPPD appears to be the most appropriate.

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