Confirming Prior and Identifying Novel Correlates of Acute Calcium Pyrophosphate Crystal Arthritis

Abstract

Objective. To investigate previously identified and novel correlates of acute calcium pyrophosphate (CPP) crystal arthritis among well-characterized cases.Methods. In this case-control study, we identified cases of acute CPP crystal arthritis using a validated algorithm (positive predictive value 81%) applied in the Partners HealthCare electronic health record (EHR). Cases were matched to general patient controls on the year of first EHR encounter and index date. Prespecified potential correlates included sex, race, and comorbidities and medications previously associated with CPP deposition/acute CPP crystal arthritis in the literature. We estimated odds ratios (ORs) and 95% confidence intervals using conditional logistic regression models adjusted for demographic characteristics, comorbidities, medications prescribed in the past 90 days, health care utilization, and multimorbidity score.Results. We identified 1,697 cases matched to 6,503 controls. Mean ± SD age was 73.7 ± 11.8 years, 56.7% were female, 80.8% were White, and 10.3% were Black. All prespecified covariates were more common in cases than controls. Osteoarthritis (OR 3.08), male sex (OR 1.35), rheumatoid arthritis (OR 2.09), gout (OR 2.83), proton pump inhibitors (OR 1.94), loop diuretics (OR 1.60), and thiazides (OR 1.46) were significantly associated with acute CPP crystal arthritis after full adjustment. Black race was associated with lower odds for acute CPP crystal arthritis compared to White race (OR 0.47).Conclusion. Using a validated algorithm to identify nearly 1,700 patients with acute CPP crystal arthritis, we confirmed important correlates of this acute manifestation of CPP deposition. This is the first study to report higher odds for acute CPP crystal arthritis among males.

Risk of cardiovascular events in patients having had acute calcium pyrophosphate crystal arthritis

“…We performed a matched cohort study using EHR data from the Mass General Brigham Research Patient Data Repository (RPDR), 1991–2017. This repository includes data for >5 million patients at Brigham and Women’s Hospital, Massachusetts General Hospital and affiliated sites 15. RPDR data include demographics, body mass index, diagnosis codes, procedure codes and prescription medications from inpatient and outpatient encounters at Mass General Brigham facilities.…”

Calcium pyrophosphate crystal deposition disease—what’s new?

“…The prevalence of CPPD reported depends much on the joints studied. In Italy, CC was among the five most prevalent musculoskeletal conditions observed with a prevalence of 0.42% [12]. In other surveys, CC was detected in 7-10% of knees together with hands, wrists, hips, and the symphysis pubis, respectively [14][15][16][17][18].…”

“…The epidemiology of manifestations and phenotypes of CPPD is in part still controversial [9,10]. Women were more frequently affected than men in two studies [11,12]. However, in a recent study, for the first time higher odds for acute CPPD among males have been reported [13].…”