Abstract
Chronic non-bacterial osteomyelitis (CNO) is a heterogenous group of immune-mediated inflammatory bone diseases, which often co-exist with other rheumatic diseases. There are no approved treatments for CNO, except non-steroid anti-inflammatory drugs (NSAID). The efficacy of methotrexate (MTX), sulfasalazine, pamidronate (PAM), anti-IL1 and TNFα-inhibitors was shown in different reports, but there are some concerns about safety of pamidronate due to long-term accumulation and persistation in bone. The aim of our study was to compare the efficacy of non-randomized different treatment approaches in pediatric patient cohort with CNO.
Highlights
Chronic non-bacterial osteomyelitis (CNO) is a heterogenous group of immune-mediated inflammatory bone diseases, which often co-exist with other rheumatic diseases
The efficacy of methotrexate (MTX), sulfasalazine, pamidronate (PAM), anti-IL1 and TNFa-inhibitors was shown in different reports, but there are some concerns about safety of pamidronate due to long-term accumulation and persistation in bone
Published: 28 September 2015 doi:10.1186/1546-0096-13-S1-P203 Cite this article as: Kostik et al.: Comparison of different treatment approaches in chronic non-bacterial osteomyelitis
Summary
Chronic non-bacterial osteomyelitis (CNO) is a heterogenous group of immune-mediated inflammatory bone diseases, which often co-exist with other rheumatic diseases. There are no approved treatments for CNO, except nonsteroid anti-inflammatory drugs (NSAID). The efficacy of methotrexate (MTX), sulfasalazine, pamidronate (PAM), anti-IL1 and TNFa-inhibitors was shown in different reports, but there are some concerns about safety of pamidronate due to long-term accumulation and persistation in bone. The aim of our study was to compare the efficacy of non-randomized different treatment approaches in pediatric patient cohort with CNO. Multifocal cases in 78.4%), fever at the onset -37.8%, spine involvement - 32.4%, positive family autoimmune diseases (AID) history - 8.1%, concomitant AID - 64.9%. NSAID was the first-line treatment for nonvertebral cases, as well as PAM for vertebral involvement. Second-line treatment includes MTX, PAM and TNFainh. Patient’s (PVAS) and physician’s (MDVAS) assessment of CNO activity we evaluated
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