1. Indomethacin (50 mg every 8 hours with tapering doses during 5 days) is usually effective.
2. Other nonsteroidal antiinflammatory drugs (NSAIDs), such as naproxen and sulindac, have efficacy similar to that of indomethacin and are often better tolerated in the elderly than is indomethacin.
C. Chronic pseudogout can be managed with NSAIDs and periodic intraarticular corticosteroid injections. Any associated diseases such as hemochromatosis and hyperparathyroidism should be managed appropriately, but treatment of the underlying disease may not prevent the recurrent attacks of arthropathy.
VII. Prophylaxis. Some evidence favors long-term prophylaxis with oral colchicine (0.6 mg PO twice daily) for patients with recurrent acute attacks. Several "letters to the editor" suggest a benefit of hydroxychloroquine, in doses similar to those used for rheumatoid arthritis, in preventing pseudogout flares.
VIII. Prognosis. Pseudogout itself has no known effect on life expectancy; associated diseases carry their own prognoses. Joint symptoms can be controlled by the treatment regimens outlined in section.VI. Patients with associated osteoarthritis may eventually require prosthetic joints if symptoms and disability become chronic and severe.
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