Pseudogout

Pubmed abstract:

Arthritis Rheum. 2007 Feb;56(2):688-92.

Comment in:
Arthritis Rheum. 2007 Sep;56(9):3172.

Methotrexate as an alternative therapy for chronic calcium pyrophosphate deposition disease: an exploratory analysis.
Chollet-Janin A, Finckh A, Dudler J, Guerne PA.

Division of Rheumatology, University Hospital of Geneva, Geneva, Switzerland.

OBJECTIVE: To evaluate the effectiveness of methotrexate (MTX), which works not only as an immunosuppressant, but also as a potent antiinflammatory agent, as an alternative therapeutic option for patients with severe calcium pyrophosphate deposition disease (CPDD) who fail to respond to standard therapy with nonsteroidal antiinflammatory drugs and/or glucocorticoids. METHODS: We analyzed, in 2 university hospitals in Switzerland, consecutive patients with CPDD that was resistant to classic treatment and were subsequently treated with MTX. Before and after initiation of MTX therapy, we quantified the frequency of pseudogout attacks, pain intensity, the number of swollen and tender joints, and inflammatory biomarkers. Clinical and biologic side effects of MTX and patients satisfaction with MTX treatment were also evaluated. RESULTS: The study included 5 patients treated with low dosages of MTX (5-20 mg/week). The mean followup time with MTX was 50.4 months (range 6-81 months). All patients reported an excellent clinical response, with marked improvement within a mean period of 7.4 weeks. A significant decrease in pain intensity (P < 0.0001), swollen and tender joint counts (P methotrexate, CPDD > pseudogout
GoutPal Pages: pseudogout, and search for pseudogout OR “sudo gout”.

NB: This is a treatment to reduce symptoms, not to tackle the underlying causes of pseudogout.

Quotes:
All 5 patients expressed at least “satisfaction” to “great satisfaction” with MTX treatment, and 1 of them even qualified it as a “miraculous drug”

limited by the small number of subjects, the retrospective evaluation, and the absence of a control group

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