Comparison of different treatment approaches in chronic non-bacterial osteomyelitis.

M Kostik,L Snegireva,D Philippov,O Kalashnikova,S Peredereev,M Dubko,V Masalova,A Pershin,A Denisov,D Malamashin,V Evseev,V Chasnyk,V Avramenko,A Mushkin,I Chikova,E Malyarova,M Bakin,D Vorypin,E Isupova

doi:10.1186/1546-0096-13-s1-p203

Abstract

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

Introduction

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

Objectives

Results

Conclusion