Schnabel, A, Nashawi, M, Anderson, C, Felsenstein, S, Lamoudi, M, Poole-Cowley, J, Lindell, E, Oates, B, Fowlie, P, Walsh, J et al (show 8 more authors)
(2022)
TNF-inhibitors or bisphosphonates in chronic nonbacterial osteomyelitis? -Results of an international retrospective multicenter study.
CLINICAL IMMUNOLOGY, 238.
109018-.
Abstract
Chronic nonbacterial osteomyelitis (CNO) can cause significant morbidity, including bone pain and damage. In the absence of clinical trials, treatments include non-steroidal anti-inflammatory drugs, corticosteroids, TNF-inhibitors (TNFi) and/or bisphosphonates. In a retrospective chart review in the United Kingdom and Germany, we investigated response to TNFi and/or pamidronate. Ninety-one patients were included, receiving pamidronate (n = 47), TNFi (n = 22) or both sequentially (n = 22). Patients with fatigue [p = 0.003] and/or arthritis [p = 0.002] were more frequently treated with TNFi than pamidronate. Both therapies were associated with clinical remission at 6 months, and reduction of bone lesions on MRI at 12 months. While not reaching statistical significance, pamidronate resulted in faster resolution of MRI lesions. Fewer flares were observed with TNFi. Failure to respond to pamidronate was associated with female sex [p = 0.027], more lesions on MRI [p = 0.01] and higher CRP levels [p = 0.03]. Randomized clinical trials are needed to confirm observations and generate evidence.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Chronic nonbacterial osteomyelitis, CNO, CRMO, Treatment, Response, Bone, TNF inhibitor, Pamidronate |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 28 Jun 2022 12:49 |
| Last Modified: | 18 Jan 2023 20:56 |
| DOI: | 10.1016/j.clim.2022.109018 |
| Open Access URL: | https://doi.org/10.1016/j.clim.2022.109018 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3157388 |
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