Table Info

Table 1.

Variables analyzed for association with calcium pyrophosphate arthritis (CPPA) in patients with gout

Variable	CPPA (%)	Non-CPPA (%)	P
Age (years)	72 ± 11	61 ± 13	< 0.001
Time from onset (years)	6.55 ± 7.02	6.61 ± 8.04	0.926
Flares (previous year)	3.59 ± 4.10	3.82 ± 5.95	0.556
GFRe (mL/min)	73 ± 29	62 ± 26	< 0.001
Serum urate (mg/dL)	9.18 ± 1.63	9.13 ± 1.46	0.349
Gender (female)	20/127 (15.7)	128/1,417 (9.0)	0.014
Polyarticular involvement	46/127 (36.2)	491/1,417 (34.7)	0.772
Tophi	43/127 (33.9)	452/1,417 (31.9)	0.650
Previous ULT	61/127 (48.0)	613/1,417 (43.3)	0.299
ULT febuxostat	18/127 (14.2)	142/1,417 (10,0)	0.086
Colchicine for prophylaxis	96/110 (87.3)	1012/1,184 (85.4)	0.607
Diuretic use	72/127 (56.7)	454/1,417 (32.0)	< 0.001
Alcohol intake (> 15g/day)	26/127 (20.5)	453/1,417 (32.0)	0.007
Hypertension	102/127 (80.3)	782/1,417 (55.2)	< 0.001
Hyperlipidemia	63/127 (49.6)	778/1,417 (54.9)	0.250
Diabetes	34/127 (26.8)	354/1,417 (25.0)	0.656
Vascular disease	64/127 (50.4)	450/1,417 (31.8)	< 0.001
Urolithiasis	8/127 (6.3)	101/1,417 (7.1)	0.725

GFRe: glomerular filtration rate estimated; ULT: urate-lowering therapy

Declarations

Acknowledgments

FPR will be always in debt to Ms. Concepción Eizaguirre and Mrs. Begoña Eizaguirre for their outstanding contribution to education.

Author contributions

FPR: Conceptualization, Investigation, Formal analysis, Writing—original draft, Writing—review & editing, Funding acquisition. MdCMC, JASdB, NS, HKE, and FL: Conceptualization, Writing—review & editing. AMHB: Writing—original draft, Validation, Writing—review & editing, Formal analysis. Nuria PH and Nerea PH: Writing—original draft, Formal analysis, Writing—review & editing. All authors read and approved the submitted version.

Conflicts of interests

Fernando Perez-Ruiz: advisor for Arthrosi, Horizon, LG, Protalix, and SOBI, speaker for Menarini. Naomi Schlesinger: advisor or review panel member: Horizon Pharma, Novartis, Sobi, Protalix, Arthrosi, and Shanton. Fernando Perez-Ruiz is Editor-in-chief of the journal Exploration of Musculoskeletal Diseases, Naomi Schlesinger is Associate Editors, and Maria del Consuelo Modesto-Caballero is Editorial Board Member, none of them was involved in the decision-making or review process for this manuscript. The other authors declare that they have no conflicts of interest.

Ethical approval

This study was approved by the Ethics Committee of OSI EEC at Cruces University Hospital [CEIC-E03/45].

Consent to participate

Informed consent to participate in the study was obtained from all participants, and the patient’s information sheet was supervised and approved by the Ethics Committee of OSI EEC at Cruces University Hospital.

Consent to publication

Not applicable.

Availability of data and materials

The dataset is available on request to authors and with previous approval by the Ethics Committee of OSI EEC.

Funding

This study was funded by the Cruces Rheumatology Association [24/01].

Copyright

References

Quilis N, Sivera F, Seoane-Mato D, Pérez-Ruiz F, Sánchez-Piedra C, Díaz-González F, et al.; Working Group Proyecto EPISER2016. Prevalence of gout in the adult general population in Spain: Estimating the proportion of undiagnosed cases. Joint Bone Spine. 2022;89:105257. [DOI] [PubMed]

Zhang W, Doherty M, Bardin T, Barskova V, Guerne P, Jansen TL, et al. European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis. Ann Rheum Dis. 2011;70:563–70. [DOI] [PubMed]

McCarty DJ. Arthritis associated with crystals containing calcium. Med Clin North Am. 1986;70:437–54. [DOI] [PubMed]

Becker MA, Schumacher HR, MacDonald PA, Lloyd E, Lademacher C. Clinical efficacy and safety of successful longterm urate lowering with febuxostat or allopurinol in subjects with gout. J Rheumatol. 2009;36:1273–82. [DOI] [PubMed]

Becker MA, Schumacher HR, Benjamin KL, Gorevic P, Greenwald M, Fessel J, et al. Quality of life and disability in patients with treatment-failure gout. J Rheumatol. 2009;36:1041–8. [DOI] [PubMed]

Balderrama CK, Rosenthal AK, Lans D, Singh JA, Bartels CM. Calcium Pyrophosphate Deposition Disease and Associated Medical Comorbidities: A National Cross-Sectional Study of US Veterans. Arthritis Care Res (Hoboken). 2017;69:1400–06. [DOI] [PubMed] [PMC]

Rho YH, Zhu Y, Zhang Y, Reginato AM, Choi HK. Risk factors for pseudogout in the general population. Rheumatology (Oxford). 2012;51:2070–4. [DOI] [PubMed] [PMC]

Richette P, Doherty M, Pascual E, Barskova V, Becce F, Castaneda J, et al. 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout. Ann Rheum Dis. 2020;79:31–8. [DOI] [PubMed]

Mandl P, D'Agostino MA, Navarro-Compán V, Geßl I, Sakellariou G, Abhishek A, et al. 2023 EULAR recommendations on imaging in diagnosis and management of crystal-induced arthropathies in clinical practice. Ann Rheum Dis. 2024;83:752–9. [DOI] [PubMed] [PMC]

10.

Smith EUR, Díaz-Torné C, Perez-Ruiz F, March LM. Epidemiology of gout: an update. Best Pract Res Clin Rheumatol. 2010;24:811–27. [DOI] [PubMed]

11.

Abhishek A, Doherty M. Epidemiology of calcium pyrophosphate crystal arthritis and basic calcium phosphate crystal arthropathy. Rheum Dis Clin North Am. 2014;40:177–91. [DOI] [PubMed]

12.

Richette P, Bardin T, Doherty M. An update on the epidemiology of calcium pyrophosphate dihydrate crystal deposition disease. Rheumatology (Oxford). 2009;48:711–5. [DOI] [PubMed]

13.

Winder M, Owczarek AJ, Mossakowska M, Broczek K, Grodzicki T, Wierucki Ł, et al. Prevalence of Hyperuricemia and the Use of Allopurinol in Older Poles-Results from a Population-Based PolSenior Study. Int J Environ Res Public Health. 2021;18:387. [DOI] [PubMed] [PMC]

14.

Oliviero F, Scanu A, Galozzi P, Gava A, Frallonardo P, Ramonda R, et al. Prevalence of calcium pyrophosphate and monosodium urate crystals in synovial fluid of patients with previously diagnosed joint diseases. Joint Bone Spine. 2013;80:287–90. [DOI] [PubMed]

15.

Ankli B, Kyburz D, Hirschmann A, Hügle T, Manigold T, Berger CT, et al. Calcium pyrophosphate deposition disease: a frequent finding in patients with long-standing erosive gout. Scand J Rheumatol. 2018;47:127–30. [DOI] [PubMed]

16.

Harrold LR, Etzel CJ, Gibofsky A, Kremer JM, Pillinger MH, Saag KG, et al. Sex differences in gout characteristics: tailoring care for women and men. BMC Musculoskelet Disord. 2017;18:108. [DOI] [PubMed] [PMC]

17.

Buford TW. Hypertension and aging. Ageing Res Rev. 2016;26:96–111. [DOI] [PubMed] [PMC]

18.

Chinchilla SP, Urionaguena I, Perez-Ruiz F. Febuxostat for the chronic management of hyperuricemia in patients with gout. Expert Rev Clin Pharmacol. 2016;9:665–73. [DOI] [PubMed]

19.

Haddad RE, Renuy A, Wiernik E, Melchior M, Zins M, Airagnes G. Proportion of At-Risk Alcohol Consumers According to the New French Guidelines: Cross-Sectional Weighted Analyses From the CONSTANCES Cohort. Int J Public Health. 2024;69:1606481. [DOI] [PubMed] [PMC]

20.

Puka K, Buckley C, Mulia N, Purshouse RC, Lasserre AM, Kerr W, et al. Behavioral stability of alcohol consumption and socio-demographic correlates of change among a nationally representative cohort of US adults. Addiction. 2023;118:61–70. [DOI] [PubMed] [PMC]

21.

Zeng C, Wei J, Terkeltaub R, Yang T, Choi HK, Wang Y, et al. Dose-response relationship between lower serum magnesium level and higher prevalence of knee chondrocalcinosis. Arthritis Res Ther. 2017;19:236. [DOI] [PubMed] [PMC]

22.

Zhang W, Doherty M, Pascual E, Barskova V, Guerne P, Jansen TL, et al. EULAR recommendations for calcium pyrophosphate deposition. Part II: management. Ann Rheum Dis. 2011;70:571–5. [DOI] [PubMed]

23.

Bashir M, Sherman KA, Solomon DH, Rosenthal A, Tedeschi SK. Cardiovascular Disease Risk in Calcium Pyrophosphate Deposition Disease: A Nationwide Study of Veterans. Arthritis Care Res (Hoboken). 2023;75:277–82. [DOI] [PubMed] [PMC]

24.

Tedeschi SK, Huang W, Yoshida K, Solomon DH. Risk of cardiovascular events in patients having had acute calcium pyrophosphate crystal arthritis. Ann Rheum Dis. 2022;81:1323–9. [DOI] [PubMed] [PMC]

25.

Akl E, Sahami N, Labos C, Genest J, Zgheib A, Piazza N, et al. Meta-Analysis of Randomized Trials: Efficacy and Safety of Colchicine for Secondary Prevention of Cardiovascular Disease. J Interv Cardiol. 2024;2024:8646351. [DOI] [PubMed] [PMC]

26.

Bardin T, Richette P. Impact of comorbidities on gout and hyperuricaemia: an update on prevalence and treatment options. BMC Med. 2017;15:123. [DOI] [PubMed] [PMC]

27.

Schoenherr JR, Waechter J, Millington SJ. Subjective awareness of ultrasound expertise development: individual experience as a determinant of overconfidence. Adv Health Sci Educ Theory Pract. 2018;23:749–65. [DOI] [PubMed]

28.

Neogi T, Jansen TLTA, Dalbeth N, Fransen J, Schumacher HR, Berendsen D, et al. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2015;74:1789–98. [DOI] [PubMed] [PMC]

29.

Abhishek A, Tedeschi SK, Pascart T, Latourte A, Dalbeth N, Neogi T, et al. The 2023 ACR/EULAR classification criteria for calcium pyrophosphate deposition disease. Ann Rheum Dis. 2023;82:1248–57. [DOI] [PubMed] [PMC]

30.

Evans PL, Prior JA, Belcher J, Mallen CD, Hay CA, Roddy E. Obesity, hypertension and diuretic use as risk factors for incident gout: a systematic review and meta-analysis of cohort studies. Arthritis Res Ther. 2018;20:136. [DOI] [PubMed] [PMC]

31.

Pérez-Ruiz F, Perez-Herrero N, Vazquez-Puente C, Modesto-Caballero MdC, Perez-Herrero N, Herrero-Beites AM. Prevalence and factors associated to diffuse idiopathic skeletal hyperostosis in gout. Explor Musculoskeletal Dis. 2023;1:121–7. [DOI]