AI Article Synopsis
- Chronic recurrent multifocal osteomyelitis (CRMO) is a rare inflammatory disorder that leads to unpredictable flare-ups and remissions, with no established randomized-controlled treatment options.
- First-line treatments include non-steroidal anti-inflammatory drugs (NSAID) and glucocorticoids, with bisphosphonates and biologic agents like anti-TNF therapy showing promising results.
- In a case study involving three children with CRMO treated with various medications, including etanercept, all showed clinical improvement, supporting the potential use of etanercept for severe, persistently active cases.
Article Abstract
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare non-infectious inflammatory disorder with unpredictable clinical course, characterized by acute exacerbations and spontaneous remissions. There are no randomized-controlled trials about treatment options. Non-steroidal anti-inflammatory drugs (NSAID) are the first-line treatment option; glucocorticoids seem to be effective; positive outcomes have been obtained with bisphosphonates. In the last few years successful use of biologic agents like anti-TNF agents has been reported. We report the cases of 3 children suffering from CRMO who were treated with NSAID, steroid, bisphosphonates and eventually received etanercept and 1 case without vertebral involvement treated with etanercept after NSAID and steroid; all cases showed clinical improvement. The mean ages at symptoms onset and diagnosis were 8 and 10 years and 10 months, respectively. Two patients presented with back pain and three had vertebral lesions. Mean interval from diagnosis to the onset of anti-TNF treatment was 14 months. According to our small experience, we suggest considering therapy with etanercept for the treatment of severe cases with persistently active disease despite multiple treatments.
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| http://dx.doi.org/10.1007/s00296-017-3877-0 | DOI Listing |
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