M.G. Whelan, BS, K. Hayashi, MD, MPH, H. Altwies, BS, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital.
S.K. Tedeschi, MD, MPH, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, and Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
J Rheumatol. 2023 Aug;50(8):1058-1062. doi: 10.3899/jrheum.2023-0031. Epub 2023 Apr 15.
Calcium pyrophosphate deposition (CPPD) disease prevalence is similar to that of gout and osteoarthritis (OA), yet CPPD outcomes research greatly lags behind research in these other forms of arthritis. We compared validated patient-reported outcome measures in patients with CPPD vs gout and OA.
Patients with CPPD were recruited from Brigham and Women's Hospital from 2018 to 2022. Presence of CPPD manifestations (acute calcium pyrophosphate [CPP] crystal arthritis, chronic CPP inflammatory arthritis, and/or OA with CPPD) was confirmed by medical record review. Baseline surveys included the Gout Assessment Questionnaire version 2.0, modified to ask about "pseudogout" rather than "gout"; Routine Assessment of Patient Index Data 3 (RAPID-3); and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). We compared responses in patients with CPPD against published gout and OA cohort studies.
Among 47 patients with CPPD, the mean age was 71.9 years and 51% were female. Sixty-eight percent had at least 1 episode of acute CPP crystal arthritis, 40% had chronic CPP inflammatory arthritis, and 62% had OA with CPPD. Pain visual analog scale scores during a flare were similar in CPPD (mean 6.8 [SD 1.9]) and gout (mean 6.7 [SD 2.6]; = 0.78). Patients with CPPD reported significantly greater unmet treatment need than patients with gout ( = 0.04). RAPID-3 scores in CPPD (mean 8.1 [SD 5.6]) were lower than in gout (mean 12.1 [SD 6.2]; < 0.01) and similar in OA (mean 6.8 [SD 6.1]; = 0.30). Patients with CPPD had significantly worse WOMAC stiffness scores than patients with mild OA, and significantly better WOMAC function scores than patients with severe OA.
Patients with CPPD may experience pain comparable to that in gout and OA and reported substantial unmet treatment needs.
焦磷酸钙沉积（CPPD）疾病的患病率与痛风和骨关节炎（OA）相似，但 CPPD 结局研究远远落后于其他形式关节炎的研究。我们比较了 CPPD 患者与痛风和 OA 患者的经过验证的患者报告的结局测量。
2018 年至 2022 年，我们从布里格姆妇女医院招募了 CPPD 患者。通过病历回顾确认 CPPD 表现（急性焦磷酸钙 [CPP] 晶体关节炎、慢性 CPP 炎症性关节炎和/或伴有 CPPD 的 OA）的存在。基线调查包括痛风评估问卷 2.0 版，修改为询问“假性痛风”而不是“痛风”；患者指数数据常规评估 3 版（RAPID-3）；和西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）。我们将 CPPD 患者的反应与已发表的痛风和 OA 队列研究进行了比较。
在 47 名 CPPD 患者中，平均年龄为 71.9 岁，51%为女性。68%至少有 1 次急性 CPP 晶体关节炎发作，40%有慢性 CPP 炎症性关节炎，62%有伴有 CPPD 的 OA。发作时 CPPD（平均 6.8 [SD 1.9]）和痛风（平均 6.7 [SD 2.6]； = 0.78）的疼痛视觉模拟评分相似。CPPD 患者报告的未满足治疗需求明显高于痛风患者（ = 0.04）。CPPD 中的 RAPID-3 评分（平均 8.1 [SD 5.6]）低于痛风（平均 12.1 [SD 6.2]； < 0.01），与 OA 相似（平均 6.8 [SD 6.1]； = 0.30）。CPPD 患者的 WOMAC 僵硬评分明显差于轻度 OA 患者，而 WOMAC 功能评分明显好于重度 OA 患者。
CPPD 患者可能经历与痛风和 OA 相似的疼痛，并报告有大量未满足的治疗需求。
