Background/Purpose: CPPD has been shown to complicate other types of inflammatory arthritis such as rheumatoid arthritis. However, only a few studies have investigated the correlation between CPPD and PsA(1). Our study aimed to determine whether there were higher rates of PsA in patients with CPPD than age and sex matched controls.

Methods: A retrospective cohort study was conducted using national Veterans’ Affairs’ database of patients who had one or more encounters with an ICD code for CPPD between January 1, 2010 and March 1, 2020. Control patients were matched to CPPD patients based on sex, year of birth, vital status, and having had an inpatient or outpatient encounter the same month as the matched case’s first encounter with the CPPD ICD code (index date). Diagnoses of PsA and psoriasis were collected, identified by the presence of two or more ICD codes at any time between January 1, 2010 and March 1, 2020, and the date of first diagnosis was recorded for PsA and psoriasis.

Results: In total 41,084 CPPD patients were matched with 119,192 controls; the sample was largely white (72.29%) and male (94.00%) with an average age of 69.350 (standard deviation: 12.989). The proportion of CPPD patients with PsA diagnosis was more than double that of controls (1.07% vs 0.37%; p< 0.0001), and more CPPD patients were diagnosed with psoriasis (3.05% vs 2.52%; p< 0.0001). After controlling for comorbid psoriasis and demographic factors, those with CPPD had higher odds of PsA diagnosis than controls (logistic regression; OR 3.550, 95% CI 2.602-4.844). 61.59% of PsA diagnoses preceded CPPD diagnosis by at least one year.  

Conclusion: This is the first case-control study demonstrating an association between CPPD and PsA. Moreover, our results suggest that PsA diagnosis precedes CPPD diagnosis which is also true in rheumatoid arthritis. Both PsA and CPPD could be triggered by trauma (2-3), and are closely associated with osteoarthritis (OA)(3-4). It also is possible that inflammatory pathways contribute to CPP crystal deposition in joints.

1.     ^1. Felten, R., Duret, P.-M., Gottenberg, J.-E., Spielmann, L., & Messer, L. (n.d.). At the crossroads of gout and psoriatic arthritis: “psout.” https://doi.org/10.1007/s10067-020-04981-0/Published

2.     2. Olivieri, I., Padula, A., D’Angelo, S., & Scarpa, R. (2008). Role of trauma in psoriatic arthritis. In Journal of Rheumatology (Vol. 35, Issue 11, pp. 2085–2087). https://doi.org/10.3899/jrheum.080668

3.     3. Rosenthal AK, Ryan LM. Calcium Pyrophosphate Deposition Disease. N Engl J Med. 2016;374(26):2575-2584. doi:10.1056/NEJMra1511117

4.     4. McGonagle, D., Hermann, K. G. A., & Tan, A. L. (2015). Differentiation between osteoarthritis and psoriatic arthritis: Implications for pathogenesis and treatment in the biologic therapy era. In Rheumatology (United Kingdom) (Vol. 54, Issue 1, pp. 29–38). Oxford University Press. https://doi.org/10.1093/rheumatology/keu328

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/higher-rates-of-psoriatic-arthritis-in-patients-with-calcium-pyrophosphate-deposition-disease-than-controls-a-retrospective-cohort-study-in-us-veterans/