%0 Journal Article
%T Treatment of Nongout Joint Deposition Diseases: An Update
%A Tristan Pascart
%A Pascal Richette
%A Ren¨¦-Marc Flipo
%J Arthritis
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/375202
%X This update develops the actual therapeutic options in the management of the joint involvement of calcium pyrophosphate deposition disease (CPPD), basic calcium phosphate (BCP) deposition disease, hemochromatosis (HH), ochronosis, oxalosis, and Wilson¡¯s disease. Conventional pharmaceutical treatment provides benefits for most diseases. Anti-interleukine-1 (IL-1) treatment could provide similar results in CPPD than in gout flares. There is only limited evidence about the efficacy of preventive long-term colchicine intake, methotrexate, and hydroxychloroquine in chronic CPPD. Needle aspiration and lavage have satisfactory short and midterm results in BCP. Extracorporeal shockwave therapy has also proved its efficacy for high-doses regimes. Phlebotomy does not seem to have shown real efficacy on joint involvement in HH so far. Iron chelators¡¯ effects have not been assessed on joint involvement either, while IL-1 blockade may prove useful. NSAIDs have limited efficacy on joint involvement of oxalosis, while colchicine and steroids have not been assessed either. The use of nitisinone for ochronotic arthropathy is still much debated, but it could provide beneficial effects on joint involvement. The effects of copper chelators have not been assessed either in the joint involvement of Wilson¡¯s disease. NSAIDs should be avoided because of the liver affection they may worsen. 1. Introduction New interest in crystal-induced arthropathies has developed over the last few years mainly through the new discoveries on gout pathophysiology and especially with the understanding of the inflammasome [1] which paved the way for new therapeutic options [2]. These breakthroughs in the field of gout have given a new insight into other crystal-induced arthropathies [3] and recent international guidelines have been produced for both the treatment of gout [4, 5] and calcium pyrophosphate deposition (CPPD) [6]. However, other crystal-induced rheumatisms such as the basic calcium phosphate (BCP) deposition disease [7] do not seem to have benefited from these new developments although they are widespread in clinical practice. Rare conditions such as hemochromatosic arthropathy [8], ochronotic arthropathy [9], Wilson¡¯s disease [10], and oxalate crystal deposition disease [11] can lead to difficult clinical situations. Other joint deposition-related entities such as cholesterol crystal arthropathy, cryoglobulin-crystal arthropathy, liquid lipid crystals arthropathy, corticosteroid crystals-induced arthritis, or Charcot-Leyden crystals deposition are exceptional and therefore not
%U http://www.hindawi.com/journals/arthritis/2014/375202/