دورية أكاديمية
أعرض في EDS

Comparison of different treatment approaches of pediatric chronic non-bacterial osteomyelitis.

التفاصيل البيبلوغرافية
العنوان: Comparison of different treatment approaches of pediatric chronic non-bacterial osteomyelitis.
المؤلفون: Kostik MM; Saint-Petersburg State Pediatric Medical University, Lytovskaya 2, Saint Petersburg, 194100, Russian Federation. kost-mikhail@yandex.ru., Kopchak OL; Kirov's Regional Children's Hospital, Kirov, Russian Federation., Chikova IA; Saint-Petersburg State Pediatric Medical University, Lytovskaya 2, Saint Petersburg, 194100, Russian Federation., Isupova EA; Saint-Petersburg State Pediatric Medical University, Lytovskaya 2, Saint Petersburg, 194100, Russian Federation., Mushkin AY; Science Research Institute of Phthisiopulmonology, Saint Petersburg, Russian Federation.
المصدر: Rheumatology international [Rheumatol Int] 2019 Jan; Vol. 39 (1), pp. 89-96. Date of Electronic Publication: 2018 Aug 31.
نوع المنشور: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8206885 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1437-160X (Electronic) Linking ISSN: 01728172 NLM ISO Abbreviation: Rheumatol Int Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [Berlin ; New York, NY] : Springer International, c1981-
مواضيع طبية MeSH: Practice Patterns, Physicians'*, Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use , Bone Density Conservation Agents/*therapeutic use , Immunosuppressive Agents/*therapeutic use , Osteomyelitis/*drug therapy, Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Methotrexate/therapeutic use ; Pamidronate/therapeutic use ; Sulfasalazine/therapeutic use ; Treatment Outcome
مستخلص: Chronic non-bacterial osteomyelitis (CNO) is a chronic inflammatory bone disease which usually manifests in children and adolescents. There are a few data about pathogenesis and treatment. The aim of the study to compare the efficacy of different treatment approaches in pediatric CNO cohort patient. Fifty two children (25 boys and 27 girls) with CNO with average age at the onset of the disease 8.4 years (5.4; 11.0), number of foci - 3.0 (2.0; 6.0, incl. multifocal cases in 80.8%). Non-steroid anti-inflammatory drugs (NSAID) was the first-line treatment for non-vertebral cases, as well as pamidronate (PAM) for vertebral involvement. Second-line treatment includes sulfasalazine (SSZ), methotrexate (MTX), PAM and tumor necrosis factor-α inhibitors (TNFα-inh). We evaluated the dynamics of pain, patient's and physician's (MDVAS) assessment with visual-analog scale (VAS) and ability to each medication to achieve remission of CNO activity. According to the NSAID, MTX, SSZ, PAM and TNFα-inh groups the following data were registered: patient's VAS: - 14.2% (p = 0.05), - 50.0% (p = 0.04), - 23.1 (p = 0.89), - 83.3% (p = 0.0001), - 73.6% (p = 0.0007); painVAS: - 21.9% (p = 0.01), - 18.6% (p = 0.13), + 36.4 (p = 0.89), - 79.7% (p = 0.00016), - 74.1%, (p = 0.0015); MDVAS: - 13.8% (p = 0.13); - 56.4% (p = 0.09), + 30.8% (p = 0.89), - 74.7%, (p = 0.0001), - 82.1 (p = 0.0015) respectively. The ability of each treatment strategy to achieve the CNO remission was 52.6%, 44.4%, 57,1%, 88.8% and 73.3%, respectively (log-rank test, p = 0.001). The efficacy of treatment approaches for CNO depended on the severity of the disease. NSAID, methotrexate, and sulfasalazine were effective in forms without spine involvement, but pamidronate and TNF-a inhibitors were useful in vertebral forms of CNO. Pamidronate and TNF-a inhibitors more extensively suppressed CNO activity. The randomized controlled trials for assessment of the efficacy and safety of these medications is mandatory to confirm these results.
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معلومات مُعتمدة: 18-515-57001 International Russian Foundation for Basic Research
فهرسة مساهمة: Keywords: Chronic non-bacterial osteomyelitis; Pamidronate; TNFα-inhibitors
المشرفين على المادة: 0 (Anti-Inflammatory Agents, Non-Steroidal)
0 (Bone Density Conservation Agents)
0 (Immunosuppressive Agents)
3XC8GUZ6CB (Sulfasalazine)
OYY3447OMC (Pamidronate)
YL5FZ2Y5U1 (Methotrexate)
تواريخ الأحداث: Date Created: 20180902 Date Completed: 20191227 Latest Revision: 20200309
رمز التحديث: 20240628
DOI: 10.1007/s00296-018-4151-9
PMID: 30171342
قاعدة البيانات: MEDLINE
الوصف
تدمد:1437-160X
DOI:10.1007/s00296-018-4151-9