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Review
. 2025 Nov 1;37(6):437-444.
doi: 10.1097/BOR.0000000000001117. Epub 2025 Aug 1.

Calcium pyrophosphate crystal deposition: 2025 update to recent epidemiological findings

Charlotte Jauffret  1   2 , Sara K Tedeschi  3 , Abhishek Abhishek  4   5 , Augustin Latourte  6   7 , Georgios Filippou  8   9 , Tuhina Neogi  10 , Tristan Pascart  2
Affiliations
Review

Calcium pyrophosphate crystal deposition: 2025 update to recent epidemiological findings

Charlotte Jauffret et al. Curr Opin Rheumatol. .

Abstract

Purpose of review: Our objective is to propose an expert opinion focusing on most important and recent developments in calcium pyrophosphate deposition (CPPD) epidemiology. We highlight recent findings published in the past 18 months and their potential implications for research and patient care.

Recent findings: We discuss new understanding of CPPD prevalence through advances in imaging modalities, advances in synovial fluid analyses (SFA), updates on disease phenotypes, and potential sources of misdiagnosis of CPPD. We present recent data regarding extra-articular associations of CPPD, particularly cardiovascular events and osteoporotic fractures. We discuss new therapeutic options. We identify barriers to improving research in CPPD, and tools currently available to overcome certain pitfalls.

Summary: Improved knowledge in the epidemiology of asymptomatic CPPD and symptomatic CPPD disease is crucial to improving recognition of this still underdiagnosed disease, and to understanding patient phenotypes and their outcomes. Future research will require prospective designs to establish the prevalence of CPPD disease phenotypes and to provide more precise data according to each phenotype, both in terms of epidemiological findings and treatment responses, to develop personalized medicine.

Keywords: calcium pyrophosphate deposition disease; clinical outcomes; clinical phenotypes; prevalence; treatments.

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References

    1. Kohn NN, Hugues RE, McCarthy DJ, et al. The significance of calcium phosphate crystals in the synovial fluid of arthritic patients: the ‘pseudogout syndrome’. II. Identification of crystals. Ann Intern Med 1962; 56:738–745.
    1. Rosenthal AK, Ryan LM. Calcium pyrophosphate deposition disease. N Engl J Med 2016; 374:2575–2584.
    1. Pascart T, Filippou G, Lioté F, et al. Calcium pyrophosphate deposition disease. Lancet Rheumatol 2024; 6:e791–e804.
    1. Jauffret C, Adinolfi A, Sirotti S, et al. Systematic literature review on calcium pyrophosphate deposition (CPPD) nomenclature: condition elements and clinical states— a Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus project. RMD Open 2025; 11:e004847.
    1. Sirotti S, Jauffret C, Adinolfi A, et al. Pseudogout, chondrocalcinosis, CPPD et al. crystal clear… or clear as mud? – the time has come to reconsider the nomenclature of calcium pyrophosphate deposition. Ann Rheum Dis 2025; S0003-4967:00894-5.

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