From the Research
The treatment of pseudogout focuses on managing acute attacks and preventing future episodes, with nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen or indomethacin being first-line treatments for acute attacks, and daily low-dose colchicine potentially helping prevent recurrent attacks in patients with frequent episodes. For acute attacks, NSAIDs like naproxen (500 mg twice daily) or indomethacin (25-50 mg three times daily) are typically continued for 7-10 days until symptoms resolve 1. Colchicine is also effective, using a low-dose regimen of 0.6 mg once or twice daily to reduce gastrointestinal side effects. For patients who cannot take NSAIDs or colchicine, corticosteroids are options, either as intra-articular injections (such as methylprednisolone 40-80 mg) or oral prednisone (starting at 30-40 mg daily and tapering over 7-10 days) 2. Joint aspiration can provide immediate relief by removing inflammatory crystals and fluid. Some key points to consider in the management of pseudogout include:
- Addressing underlying conditions like hyperparathyroidism or hemochromatosis is crucial for prevention
- Maintaining joint mobility through physical therapy and regular, gentle exercise helps preserve function
- Weight management reduces stress on affected joints, particularly knees and hips
- Unlike gout, there are no medications that specifically lower calcium pyrophosphate crystal formation, as the exact mechanism of crystal deposition remains incompletely understood 3, 4, 5. It's also important to note that while the provided evidence primarily discusses gout, the principles of managing acute attacks and preventing future episodes can be applied to pseudogout, with a focus on symptom management and addressing underlying conditions.