Journal article
Update on treatment responses and outcome measure development in chronic nonbacterial osteomyelitis (CNO)
Current opinion in rheumatology, Vol.35(5), pp.255-264
09/2023
DOI: 10.1097/BOR.0000000000000954
PMID: 37433220
Abstract
Purpose of review To review recent trends in treatment and recent progress in developing outcome measures needed for chronic nonbacterial osteomyelitis (CNO) clinical trials. Recent findings CNO is an autoinflammatory bone disease. In a minority of patients, the disease is genetically driven, and diagnosis can be made by DNA sequencing. However, for nonsyndromic CNO there is no diagnostic test. The number of children with CNO appears to be increasing and damage is common. Increases in CNO diagnosis is due to raised awareness, increased availability of whole-body magnetic resonance imaging and rising incidence. Treatment remains empiric and it is unclear which second line treatment is superior. Tumor necrosis factor inhibitors (TNFi) and bisphosphonates continue to be used as second line agents for nonsteroidal anti-inflammatory drugs (NSAID) refractory CNO; newer immune modulatory medications are used if this fails. Validated classification criteria, clinical outcome measures and imaging scoring standards are needed for successful clinical trials. Summary Best treatment for NSAID refractory CNO remains unclear. Classification criteria, clinical outcomes measures and standardized imaging scoring have been developed or are near completion. This will facilitate robust clinical trials in CNO with the goal of having approved medications for this painful disease.
Details
- Title: Subtitle
- Update on treatment responses and outcome measure development in chronic nonbacterial osteomyelitis (CNO)
- Creators
- Shwetha Ramachandran - Seattle Children's HospitalYongdong Zhao - Seattle Children's HospitalPolly J. Ferguson - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Current opinion in rheumatology, Vol.35(5), pp.255-264
- DOI
- 10.1097/BOR.0000000000000954
- PMID
- 37433220
- ISSN
- 1040-8711
- eISSN
- 1531-6963
- Language
- English
- Electronic publication date
- 07/07/2023
- Date published
- 09/2023
- Academic Unit
- Stead Family Department of Pediatrics; Rheumatology, Allergy, and Immunology
- Record Identifier
- 9984443055302771
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