Consensus Treatment Plans for Chronic Nonbacterial Osteomyelitis Refractory to Nonsteroidal Antiinflammatory Drugs and/or With Active Spinal Lesions
Year: 2017
Type: article
Abstract: OBJECTIVE: To develop standardized treatment regimens for chronic nonbacterial osteomyelitis (CNO), also known as chronic recurrent multifocal osteomyelitis (CRMO), to enable comparative effectiveness treatment studies. METHODS: Virtual and face-to-face discussions and meetings were held within the CNO/CRMO subgroup of the Childhood Arthritis and Rheumatology Research Alliance (CARRA). A literature search was conducted, and CARRA membership was surveyed to evaluate available treatment data and identify current treatment practices. Nominal group technique was used to achieve consensus on treatment plans for CNO refractory to nonsteroidal antiinflammatory drug (NSAID) monotherapy and/or with active spinal lesions. RESULTS: Three consensus treatment plans (CTPs) were developed for the first 12 months of therapy for CNO patients refractory to NSAID monotherapy and/or with active spinal lesions. The 3 CTPs are methotrexate or sulfasalazine, tumor necrosis factor inhibitors with optional methotrexate, and bisphosphonates. Short courses of glucocorticoids and continuation of NSAIDs are permitted for all regimens. Consensus was achieved on these CTPs among CARRA members. Consensus was also reached on subject eligibility criteria, initial evaluations that should be conducted prior to the initiation of CTPs, and data items to collect to assess treatment response. CONCLUSION: Three consensus treatment plans were developed for pediatric patients with CNO refractory to NSAIDs and/or with active spinal lesions. Use of these CTPs will provide additional information on efficacy and will generate meaningful data for comparative effectiveness research in CNO.
Source: Arthritis Care & Research
DOI: 10.1002/acr.23462
Authors: Yongdong Zhao, Eveline Y. Wu, Melissa S. Oliver, Ashley M. Cooper, Matthew L. Basiaga, Sheetal S. Vora, Tzielan C. Lee, Emily Fox, Gil Amarilyo, Sara M. Stern, Jeffrey A. Dvergsten, Kathleen A. Haines, Kelly A. Rouster‐Stevens, Karen B. Onel, Julie Cherian, Jonathan S. Hausmann, Paivi Miettunen, Tania Cellucci, Farzana Nuruzzaman, Angela Taneja, Karyl S. Barron, Matthew C. Hollander, Sivia K. Lapidus, Suzanne C. Li, Seza Ozen, Hermann Girschick, Ronald M. Laxer, Fatma Dedeoglu, Christian M. Hedrich, Polly J. Ferguson
Institutions: Seattle Children's Hospital, University of Washington, University of North Carolina at Chapel Hill, Stanford University, Children's Mercy Hospital, Levine Children's Hospital, Tel Aviv University, Schneider Children's Medical Center, University of Utah, Duke Children's Hospital & Health Center, Hackensack University Medical Center, Emory University, Children's Healthcare of Atlanta, Hospital for Special Surgery, Stony Brook Children's Hospital, Boston Children's Hospital, Beth Israel Deaconess Medical Center, University of Calgary, McMaster Children's Hospital, National Institutes of Health, National Institute of Allergy and Infectious Diseases, University of Vermont Medical Center, Goryeb Children's Hospital, Hacettepe University, Klinikum im Friedrichshain, University of Toronto, Hospital for Sick Children, University of Liverpool, Alder Hey Children's NHS Foundation Trust, University Hospital Carl Gustav Carus, Technische Universität Dresden, University of Iowa
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2767736224