How is calcium pyrophosphate dihydrate crystal deposition disease (CPPD, or pseudogout) treated?

The treatment of CPPD is similar to the treatment of acute gout attacks with anti-inflammatory medication. Uric acid-lowering drugs are not prescribed. Symptoms are often relieved within 24 hours after beginning treatment with anti-inflammatory medications.

The goals of treatment are to relieve pain and inflammation, and prevent recurrent attacks that could lead to significant pain and joint damage.

The type of treatment prescribed will depend on several factors, including the person's age, type of other medicines they're taking, overall health, medical history and the severity of the attack.

Anti-inflammatory drugs

Anti-inflammatory drugs are usually continued until the CPPD attack completely resolves. If side effects from the therapy occur, treatment may be changed to a different medicine. Your healthcare provider will discuss the potential side effects with you.

  • Colchicine is usually prescribed for CPPD attacks. At low doses, it can be prescribed for a longer period of time to reduce the risk of recurrent attacks of CPPD.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), especially if colchicine cannot be prescribed, are used to treat CPPD attacks. Certain patients cannot take these medications, such as those who have poor kidney function, bleeding disorders, stomach or digestive disease, heart disease and certain other health complications. Types of NSAIDs include aspirin, ibuprofen and naproxen.
  • Corticosteroids (also called steroids) may be prescribed for people who cannot take NSAIDs or colchicine. Steroids also work by decreasing inflammation. Steroids can be injected into the affected joint or given as pills. (Steroids shouldn't be used in certain cases.)
  • Certain medications, such as anakinra and canakinumab, have been shown to be beneficial in the treatment of the acute attack. However, as of 2020 these have not yet been approved by the FDA.

Side effects of medicines

Not all patients will develop side effects from these medicines. How often any side effect occurs varies from patient to patient. The occurrence of side effects depends on the dose, type of medicine, length of treatment, concurrent illnesses and other medications the patient may be taking.

Some side effects are more serious than others. Before any medicine is prescribed, your healthcare provider will discuss with you the potential benefits and risks of taking the medications.

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