Treatment of Patients with CPPD Disease: Where Do We Begin and Where Are We Going?

Calcium pyrophosphate deposition (CPPD) disease is a common crystalline arthritis in older adults, yet few data are available to guide management. In contrast to gout--another common crystalline arthritis for which chronic treatment can reduce the burden of monosodium urate crystals--targeted therapies to prevent formation of or dissolve calcium pyrophosphate (CPP) crystals do not currently exist. Patients with CPPD disease identify substantial unmet treatment needs. Current treatment paradigms focus on managing joint pain and inflammation using medications that have generally not been rigorously tested in CPPD disease. Challenges to effectively treating CPPD disease include: confusing terminology, a spectrum of clinical manifestations, under-diagnosis, difficulties in symptom attribution, and lack of disease-modifying therapies. This review provides an overview of the issues, author's approach to treatment, and review of the evidence base. Ongoing and future trials in CPPD disease are outlined.