Treating Pseudogout

Dr. John Wade, MD, FRCPC, Rheumatologist, talks about how pseudogout is treated.

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Dr. John Wade, MD, FRCPC, Rheumatologist, talks about how pseudogout is treated.
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Featuring Dr. John Wade, MD, FRCPC, Rheumatologist

Duration: 3 minutes, 50 seconds

The treatment of pseudogout is fairly straightforward. If one has pain and swelling in a single joint, then often, the most effective way of dealing with it is to put a cortisone injection into that joint. Sometimes if it’s in a joint that it’s hard to do, that’s not always feasible. But if you are able to inject the joint, that’s what your specialist will probably do.

If it’s a number of joints, or it’s difficult to inject the joint, then your doctor will look at other medications to treat the acute inflammation. As with other types of arthritis, non-steroidal anti-inflammatories, some medications like ibuprofen and naproxen are very effective in treating the symptoms of acute pain and swelling of pseudogout. And if there are no contraindications to anti-inflammatories, then this may be a very effective treatment to treat your symptoms of pseudogout.

If you’re not able to use anti-inflammatories because you have problems such as an ulcer, or you have kidney problems, or you have high blood pressure problems, there is a medication called colchicine, which can be very effective to treat pseudogout. This medication is also used to treat gout. Colchicine is a pill, and you can give the pill once a day or two or three tablets a day to reduce the symptoms of the pain and swelling in the joint, and also to keep the symptoms away.

Colchicine is a medication you need to respect, because it has side effects. Side effects of colchicine commonly include nausea and diarrhea. And if you push the dose of colchicine too high, sometimes the side effects of the medication are worse than the symptoms of the disease.

So your specialist will recommend you take one, two, three, perhaps colchicine for the first day. And then subsequently they may recommend that you reduce the dose of the colchicine in the coming days and then after a number of days, it would be recommended that you stop or come off the colchicine. Occasionally, pseudogout can be a chronic condition, and there are some times that your specialist will recommend that you stay on very low-dose colchinine on a daily basis. Sometimes you can reduce that to every other day.

If you can’t take colchicine and you can’t take anti-inflammatories, there are some newer medications that are very effective in treating pseudogout. Those medications are biologic drugs, known as IL-1 inhibitors. The most common IL-1 inhibitor readily available is a drug called anakinra. Anakinra is a drug you give yourself, or a nurse gives you, on a daily basis. The dose is 100mg in a prefilled syringe. You will inject it under the skin, and usually taking anakinra 100 milligrams daily for three to six days is an extremely effective way of resolving the acute symptoms of pseudogout, if you fail the other therapies.

If you have any questions or concerns about the treatment of pseudogout, speak to your healthcare provider or your specialist.

Presenter: Dr. John Wade, Rheumatologist, Vancouver, BC

Local Practitioners: Rheumatologist

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.