Efficacy of conservative treatment of chronic multiple nonbacterial osteomyelitis in adults based on one-year follow-up results

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BACKGROUND: Chronic multiple nonbacterial osteomyelitis is an orthopaedic autoinflammatory disease of bones and joints of unclear aetiology, characterised by the formation of multiple foci of osteitis refractory to antibiotic therapy and surgical treatment, occurring predominantly before the age of 18 years. Data on the treatment of adult chronic multiple nonbacterial osteomyelitis are limited due to the orphan character of the disease and the rarity of its onset in adults.

AIM: To present data on the efficacy of conservative treatment of adult chronic multiple nonbacterial osteomyelitis after one-year follow-up.

MATERIALS AND METHODS: 12 patients aged 18 years and older with a histologically confirmed diagnosis of chronic multiple nonbacterial osteomyelitis were followed up. Clinical, demographic and laboratory data of the patients were recorded.

RESULTS: The sex and age structure of the studied group of the patients: 7 women (58.33%), 5 men (41.67%); the average age of the patients was 37.35 ± 15.5 years. Monofocal forms of chronic multiple nonbacterial osteomyelitis were observed in 8 cases (66.67%), multifocal – in 4 cases (33.33%). Drug therapy in the study group: all the patients (100%) received non-steroidal anti-inflammatory drugs, 3 patients (25.0%) received glucocorticosteroids per os; cytostatics – by 7 patients (58.33%), bisphosphonates – by 3 patients (25.0%), genetically engineered biological therapy – by 5 patients (41.67%). Therapeutic treatment of chronic multiple nonbacterial osteomyelitis was started after surgical treatment in 6 patients (50.0%); in 6 patients (50.0%) conservative treatment was prescribed immediately after diagnosis. The conservative treatment was effective: after the beginning of adequate drug therapy; no surgical reatment was performed; stable clinical and laboratory remission of the disease without relapses of osteitis was observed.

CONCLUSIONS: In a typical group of adult patients with chronic multiple nonbacterial osteomyelitis, conservative treatment with the use of immunosuppressive treatment allows to achieve control over the disease activity with the absence of osteitis recurrences during a year of observation.

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作者简介

Ekaterina Bandurko

North-Western State Medical University named after I.I. Mechnikov

编辑信件的主要联系方式.
Email: filonenckok@yandex.ru
ORCID iD: 0000-0002-3561-4745
SPIN 代码: 9895-9119
俄罗斯联邦, Saint Petersburg

Alena Petukhova

Lomonosov Inter-District Hospital named after I.N. Yudchenko

Email: alenaarifovna@mail.ru
ORCID iD: 0000-0001-7696-981X
SPIN 代码: 6883-7375
俄罗斯联邦, Saint Petersburg

Irina Patrikeeva

Regional Clinical Hospital No. 1

Email: irapatrikeeva@gmail.com
ORCID iD: 0000-0003-0530-0080
俄罗斯联邦, Tyumen

Maksim Buyakov

North-Western State Medical University named after I.I. Mechnikov

Email: maksim.buyakov@szgmu.ru
ORCID iD: 0009-0000-3683-9236
俄罗斯联邦, Saint Petersburg

Yana Leyneman

North-Western State Medical University named after I.I. Mechnikov; Clinical Rheumatology Hospital No. 25 named after V.A. Nasonova

Email: leika15@yandex.ru
ORCID iD: 0000-0003-2538-8112
SPIN 代码: 4832-4133

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Lidia Martynova

North-Western State Medical University named after I.I. Mechnikov

Email: lidiya.martynova@szgmu.ru
ORCID iD: 0000-0002-5274-3389
俄罗斯联邦, Saint Petersburg

参考

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  2. Girschick HJ, Raab P, Surbaum S, et al. Chronic non-bacterial osteomyelitis in children. Ann Rheum Dis. 2005;64(2):279–285. doi: 10.1136/ard.2004.023838
  3. Roderick MR, Shah R, Rogers V, et al. Chronic recurrent multifocal osteomyelitis (CRMO) — advancing the diagnosis. Pediatr Rheumatol Online J. 2016;14(1):47. doi: 10.1186/s12969-016-0109-1
  4. Giedion A, Holthusen W, Masel LF, Vischer D. Subacute and chronic “symmetrical” osteomyelitis. Ann Radiol (Paris). 1972;15(3):329–342. (In multiple languages)
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  6. Filonenko E, Mazurov V, Inamova O, et al. An effective therapeutic treatment of chronic recurrent multifocal osteomyelitis (CRMO) in adults. A series of 11 clinical cases. In: Abstract book of the 22nd ECIM Congress 2024. EJCRIM. 2024;11(Sup1):1081. [Abstract:2962]. Available from: https://www.ejcrim.com/index.php/EJCRIM/article/view/4742
  7. Filonenko EP, Petuhova AA, Mazurov VI, et al. Multiple nonbacterial osteomyelitis: features of the course, diagnosis, treatment. A series of 9 clinical observations. In: Rheumatology Days in St. Petersburg – 2023. All-Russian Congress with International Participation, St. Petersburg, October 19-20, 2023: collection of abstracts. Saint Petersburg: Chelovek i ego zdorov’e; 2023. P. 175–177. (In Russ.) EDN: XDPFVA
  8. Filonenko EP, Petuhova AA, Patrikeeva IM, et al. Chronic multifocal osteomyelitis of adults as a general therapeutic problem. A series of 10 clinical observations. Terapiya. 2023;9(S7(69)):314–315. EDN: WJDNZL doi: 10.18565/therapy.2023.7suppl.1-381
  9. Filonenko E.P., Petuhova A.A., Gajdukova I.Z. Advantages of therapeutic treatment of chronic multiple nonbacterial osteomyelitis in adults based on the results of one year of observation. In: Rheumatology Days in St. Petersburg – 2024: All-Russian Congress with International Participation, St. Petersburg, October 17-18, 2024: collection of abstracts. Saint Petersburg; 2024. P. 181–182. (In Russ.)
  10. Taddio A, Ferrara G, Insalaco A, et al. Dealing with chronic non-bacterial osteomyelitis: a practical approach. Pediatr Rheumatol Online J. 2017;15(1):87. doi: 10.1186/s12969-017-0216-7

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