Topics:
Rheumatology • Crystal Arthritis
How do you approach using DMARDs for patients with CPP arthritis who have frequent flares?
For example, I have a patient who has frequent (monthly) large to medium joint flares (Knee, Ankle) with crystal proven disease. Did not tolerate colchicine. Has osteoporosis and so would not prefer daily low dose prednisone. Would you offer or consider hydroxychloroquine, methotrexate, anti-IL-1 therapy, anti-IL-6 therapy, or others?
Answer from: at Academic Institution
As far as I know, none of these agents are proven to prevent CPPD flares. Colchicine for acute flares. If someone is aware of evidence that any of these other choices work, I would be glad to hear about them. I have a patient with Gittleman's syndrome who had severe CPPD with almost constant flares....
Sign in or Register to read more
Answer from: at Academic Institution
In the late 1970s, Dr. Ralph Schumacher in Philadelphia published the results of synovial biopsies he performed in patients with crystal-proven chronic pseudogout. The pathology could not be distinguished from synovial biopsies in patients with rheumatoid arthritis. During my 48-year career, I have ...