Tocilizumab in symptomatic calcium pyrophosphate deposition disease: a pilot study.

Calcium pyrophosphate (CPP) deposition disease (CPPD) is a prevalent condition characterised by the presence of CPP crystals in articular tissues, especially hyaline cartilage and fibrocartilage. It is most frequently idiopathic, but CPPD may also be associated with other metabolic disorders, such as primary hyperparathyroidism, hereditary hemochromatosis or hypomagnesemia (eg, in a context of Gitelman’s disease).1 Some mutations, such as in ANKH , have also been described in familial forms of the disease.2 CPPD is a cause of acute or chronic inflammatory arthritis. The management of CPP crystal–induced arthritis has been extrapolated from that of gout flares and includes colchicine, non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids.1 In cases of failure of or contraindications to these drugs, case series suggested that the interleukin 1 (IL-1) inhibitor anakinra was an alternative, especially in acute CPP arthritis.3 However, IL-1 inhibitors may be ineffective or induce …