From the Research
Yes, pseudogout can be recurring, and the most effective management approach is often a combination of treating acute episodes and addressing underlying conditions that contribute to calcium pyrophosphate crystal deposition in joints. Many patients who experience an initial attack of pseudogout will have subsequent episodes throughout their lifetime, with recurrences varying in frequency and severity 1. Treatment for acute episodes typically includes nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen or indomethacin, colchicine, or joint aspiration with corticosteroid injection. For patients with frequent recurrences, preventive strategies may include daily low-dose colchicine, low-dose NSAIDs, or medications that lower calcium pyrophosphate crystal formation like magnesium supplements or hydroxychloroquine.
Some key points to consider in managing pseudogout include:
- The importance of addressing underlying conditions such as hyperparathyroidism, hemochromatosis, or hypothyroidism, which may contribute to the development of pseudogout 2
- The use of colchicine as a prophylactic agent in managing recurrent attacks, and its potential mechanisms of action on the NACHT, LRR and PYD domains-containing protein 3 (NALP-3) inflammasome of the innate immune system 2
- The potential role of CPPD crystal deposition in degenerative joint disease, and the use of targeted anticrystal therapies as potential disease-modifying drugs 2
It's worth noting that the evidence from older studies, such as those from 1976 3, may not be directly relevant to current management approaches for pseudogout, and should be considered in the context of more recent and higher-quality studies, such as those from 2018 1 and 2012 2. The most recent and highest-quality study, from 2018, provides the most up-to-date guidance on the diagnosis and treatment of pseudogout, and should be prioritized in clinical decision-making 1.