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2014 ; 2014
(ä): 375202
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Treatment of nongout joint deposition diseases: an update
#MMPMID24895535
Pascart T
; Richette P
; Flipo RM
Arthritis
2014[]; 2014
(ä): 375202
PMID24895535
show ga
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.