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Biologic therapy in refractory chronic non-bacterial osteomyelitis of childhood
Rheumatology, 05/05/2010
Eleftheriou D et al. – We present a preliminary experience of using biological therapies to treat children with CRMO and SAPHO in conjunction with other immunosuppression.
Methods- Retrospective descriptive case series of 4 children with refractory disease treated with biologics
- Disease activity was assessed at predetermined time points (T = 0, T = 6 weeks and T = 12 months after the start of biologic therapy, and at latest follow-up) using a combination of clinical examination and radiological findings: a 10 cm pain and physician visual analogue scale; the Childhood Health Assessment Questionnaire as an assessment of disability; and changes in markers of systemic inflammation
- Initial improvement in all parameters assessed for all three children treated with TNF- blockade, although the third case had to discontinue the therapy due to a suspected (but unconfirmed) fungal skin infection
- Anakinra treatment alleviated the symptoms in the fourth patient at 6 weeks, but there was no sustained response to treatment at 1-year follow-up
