SAT0444 DETECTION OF CLINICAL FORMS AND RISK FACTORS OF CPPD DEPENDING ON AGE
Authors: Olga Sheliabina, Maria Chikina, Maxim ElisEev
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> CPPD is more often diagnosed in elderly and old age. The age peculiarities of the disease are not studied well. Objectives: to assess clinical forms of CPPD, impact of risk factors and concomitant diseases depending on age. Methods: the study included 113 patients (59 women and 54 men) with verified diagnosis of CPPD (according to McCarty criteria); all had calcium pyrophosphate dehydrate depositions in synovial fluid. The mean age was 60.2±11.8 years. Roentgenography of knee joints was conducted in anteroposterior and lateral views, of hands – in frontal view. The patients were divided into two groups: &lt;55 years – 38 patients, with the mean age of 46.7±7.1 years; and &gt;55 years – 75 patients, with the mean age of 65.5±7.8 years. The study compared clinical characteristics according to the classification (presence of acute or chronic arthritis, osteoarthritis (OA) with CPP crystals, VAS pain assessment, presence of chondrocalcinosis of hands and knees according to roentgenography images, presence in past history of injuries and familial chondrocalcinosis, and presence of hypomagnesemia, hyperparathyroidism); presence of concomitant diseases (rheumatoid arthritis (RA), gout, chronic kidney disease (CKD) (over stage 3 GFR &lt;60 mL/min/1.73m<sup>2</sup> using the MDRD formula), reception of diuretics. Results: chronic arthritis was detected more often in the patients &gt;55 years (63 pts (84%) as against the patients &lt;55 years (13 pts (34%)) (p=0.001). On the contrary, acute arthritis was registered more often in the patients &lt;55 years (in 10 pts (26%) than in the patients &gt;55 years (in 4 pts (5%) (p=0.014), as well as OA with CPP crystals – in 15 pts (40%) &lt;55 years and in 8 pts (11%) &gt;55 years (p=0.003). The mean VAS in the group &gt;55 years was 51±20 mm and in the group &lt;55 years - 40±20 mm. During the past year, reception of NSAIDs or colchicine due to painful joints was significantly more often needed by the patients &gt;55 years - 68 pts (91%) than the patients &lt;55 years – 29 pts (76%) (p=0.005). Familial chondrocalcinosis was registered equally often in the patients &lt;55 years - 6 pts (16%) and in the patients &gt;55 years – 2 (3%) (p=0.46). According to the roentgenography images, knee chondrocalcinosis was significantly more often registered in the patients &gt;55 years – 49 pts (65%) than in the patients &lt;55 years – 14 pts (37%) (p=0.001). According to the hands roentgenography, chondrocalcinosis was detected equally often in the patients &lt;55 years – 21 pts (55%) and in the patients &gt;55 years – 36 pts (48%). Hyperparathyroidism was almost equally often detected in the patients &gt;55 years – in 8 pts (11%) and in the patients &lt;55 years – 6 pts (16%) (p=0.48), as well as its combination with gout in 20 pts (27%) and 8 pts (21%) respectively (p=0.44); hypomagnesemia was registered in 1 patient (3%) &lt;55 years, and its combination with rheumatoid arthritis was not registered in the patients &lt;55 years, whilst in the patients &gt;55 years it was detected in 5 pts (7%) (p=0.09). Presence of CKD was detected in 2 pts (6%) &lt;55 years and in 10 pts (13%) &gt;55 years (p=0.2). Its combination with OA was registered significantly more often in the patients &gt;55 – in 59 pts (79%) than in the patients &lt;55 years - 9 pts (24%) (p=0.005). Diuretics were more often received by the patients &gt;55 years – 27 pts (36%) than by the patients &lt;55 years - 5 pts (13%) (p=0.006). There were no significant differences detected in the presence of joint injuries in past history – in 22 pts (58%) &lt;55 years and in 35 pts (47%) &gt;55 years. <h3>Conclusion</h3> Prevalence of CPPD in young people may be underestimated; the frequency of detection of factors associated with CPPD in different age groups is identical, excluding OA, which is more often diagnosed in patients &gt;55 years. The patients with CPPD &gt;55 years are more often diagnosed with chronic form of arthritis, they more often need to receive NSAIDs and colchicine and more often are diagnosed with chondrocalcinosis of the knee. <h3>Disclosure of Interests</h3> Olga Sheliabina Speakers bureau: Berlin Chemie Menarini, Maria Chikina: None declared, Maxim ElisEev : None declared