Abstract
Chronic calcium pyrophosphate crystal arthritis is a clinical consequence of the formation and deposition of these crystals in joints and can result in persistent arthritis. Curative treatment would require the removal of crystals from joints and tissues, but to date all agents tested have proven ineffective. Management of the inflammatory manifestations of chronic calcium pyrophosphate disease includes glucocorticoids, non-steroidal anti-inflammatory drugs, or colchicine, and responses are usually satisfactory. However, in some patients, the response to these agents is poor or they are contraindicated. Methotrexate had been reported as a promising option in small case series; however, in a recent issue of Arthritis Research & Therapy, a clinical trial failed to confirm the anticipated benefits. Here, we discuss some issues that might have influenced the results of the study, before deciding to abandon methotrexate as a therapeutic option for patients with chronic calcium pyrophosphate arthritis.
Highlights
Chronic calcium pyrophosphate crystal arthritis is a clinical consequence of the formation and deposition of these crystals in joints and can result in persistent arthritis
Before MTX is abandoned as a therapeutic option for patients with CPP disease (CPPD), it merits analyzing whether any methodological issue might have influenced the results of the trial
The authors selected DAS44 (44-joint disease activity score) as the main evaluation technique, and the sample size was calculated on the basis of results of previous trials in rheumatoid arthritis (RA)
Summary
Chronic calcium pyrophosphate crystal arthritis is a clinical consequence of the formation and deposition of these crystals in joints and can result in persistent arthritis. Editorial We thank Finckh and colleagues [1] for their effort in performing a prospective controlled study of methotrexate (MTX) in patients with chronic calcium pyrophosphate (CPP) crystal arthritis, which is a less common clinical consequence of the formation and deposition of these crystals in joints and can result in persistent arthritis usually in older patients.
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