ATTACk Project
Assessing of The diagnosis and TreAtment of Crystal-induced arthritis

ATTACk Project

Project Leader

Prof. Leonardo Punzi - UOC di Reumatologia Dipartimento di Medicina DIMED, Azienda Ospedaliera-Università di Padova,

GdS SIR on crystal-induced arthritis (SIR-AMC).


Crystal-induced arthritis, gout and calcium pyrophosphate arthropathy (CPP) are frequently found in the general population. The clinical presentation is classically characteristic, although a precise diagnostic definition can only be achieved by a synovial fluid analysis, which will detect the presence of monosodium urate crystals (MSU) and CPP, and through ultrasound investigation. Important international epidemiological studies have shown that crystal-induced arthritis is the most common inflammatory arthropathy in the adult population, particularly among males, and is increasing in frequency, especially among females. Despite this, AMC is often misdiagnosed and treated inappropriately with a substantial impact on the quality of life of patients and on exposure to the risk of adverse events. Therefore, there is an urgent need to establish, disseminate and apply the knowledge regarding the diagnosis and treatment of crystal-induced arthritis and provide clinical research with the instruments to develop new therapeutic strategies and new drugs for the management of these diseases.

The innovative feature of the project

The ATTACK study aims to create the first prospective cohort of patients with crystal-induced arthritis since the characterising event of the disease, the acute arthritis attack. This project makes it possible to chart the patient’ course by analysing the initial diagnostic phase, the choice of treatment for the acute attack and long-term management of the patient, pinpointing the critical issues and studying prognostic factors and efficacy of drugs in clinical practice.


Primary objective

  • Evaluate the appropriateness of the diagnostic and therapeutic phases of the management of patients with gout and CPP arthritis

Secondary objective

  • Identify prognostic factors of damage and disability
  • Evaluate the efficacy and safety of drugs in clinical practice
  • Assess adherence to the recommendation on clinical outcome
  • Validate the application of the perspective ACR / EULAR criteria for the diagnosis of gout
  • Validate a disease activity for gout
  • Develop and validate diagnostic and clinical tools for CPP arthritis