Combination Therapy with Methotrexate and Etanercept for Refractory Chronic Recurrent Multifocal Osteomyelitis: Figure 1.

Eisenstein, Eli M.; Syverson, Grant; Vora, Sheetal S.; Williams, Calvin B.

doi:10.3899/jrheum.100431

Cited by 28 publications

(17 citation statements)

References 19 publications

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“…TNF-α blockers have also been proven to be effective [16,[82][83][84][85]. There is no consensus, however, on the drug regimen that should be used.…”

Section: Treatmentmentioning

confidence: 98%

Chronic Recurrent Multifocal Osteomyelitis

Costa-Reis

Sullivan

2013

J Clin Immunol

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Chronic recurrent multifocal osteomyelitis is a rare auto-inflammatory condition that primarily affects children and adolescents. It presents with recurrent episodes of pain related to the presence of foci of sterile bone inflammation. The long bones of the lower extremities are more frequently affected and the spine can also be involved. Imaging studies, including whole-body magnetic resonance, are important for diagnosis and detection of asymptomatic lesions. Bone biopsies may be necessary to exclude other diseases, including malignancy and infections. Non-steroidal anti-inflammatory drugs cause relief of symptoms in the majority of cases. Bisphosphonates and TNF-α blockers are alternatives for patients who do not respond or who have spinal involvement.

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“…TNF-α blockers have also been proven to be effective [16,[82][83][84][85]. There is no consensus, however, on the drug regimen that should be used.…”

Section: Treatmentmentioning

confidence: 98%

Chronic Recurrent Multifocal Osteomyelitis

Costa-Reis

Sullivan

2013

J Clin Immunol

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“…32 There are reports of treatment success with various DMARDs, including methotrexate, sulfasalazine, azathioprine, and colchicine; efficacy with short-course corticosteroid therapy has also been reported, but long-term side effects limit its usefulness. 15,16,32,48,50,68,92,104 In Borzutzky's cohorts, methotrexate (but not sulfasalazine) was significantly more effective than NSAIDs in treating CNO, but only a partial response was seen in most methotrexate-treated patients and some individuals did not improve on this treatment. 32 Individuals who fail standard therapy are typically treated with a biologic disease modifying anti-rheumatic medication, or with a bisphosphonate.…”

Section: Managementmentioning

confidence: 96%

Autoinflammatory Diseases Predominantly Affecting Bone and Joints

Ferguson

Goldbach‐Mansky

2014

Stiehm's Immune Deficiencies

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“…Otros fármacos han sido reportados de forma anecdó-tica en casos refractarios como metotrexate, sulfasalazina, colchicina e interferón, pero no hay indicaciones precisas y falta evidencia que soporte su uso en estos sujetos [47][48][49] .…”

Section: Tratamientounclassified

Osteomielitis crónica multifocal recurrente: estado del arte

Eusse

Velásquez-Franco

Navas

2016

MedUPB

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RESUMENLa osteomielitis crónica multifocal recurrente es una enfermedad autoinflamatoria que se caracteriza por focos estériles de inflamación ósea que producen dolor recurrente. Es una entidad poco frecuente que tiene como manifestaciones cardinales la presencia de lesiones óseas inflamatorias en las regiones metaepifisiarias de los huesos largos que predomina en miembros inferiores. Esta enfermedad, con frecuencia asociada con sínto-mas sistémicos y lesiones en piel, hace parte del grupo de enfermedades que conforma el síndrome: artritis-dermatitis. Los hallazgos radiológicos más comunes son las áreas de osteolisis rodeadas de un halo esclerótico delgado, sin reacción perióstica asociada o la formación de secuestros óseos. La resonancia nuclear magnética permite hacer una detección precoz de la entidad y facilita su diagnóstico diferencial, principalmente, con infecciones y tumores óseos. El tratamiento está basado en la información obtenida mediante reportes de caso y series de pacientes y consiste en el uso de antiinflamatorios no esteroideos y en casos refractarios, bisfosfonatos y antagonistas del factor de necrosis tumoral alfa. El pronóstico de esta enfermedad, en general, es bueno, con un curso clínico benigno y autolimitado, en la mayoría de los casos. Palabras clave: osteomielitis; inflamación; hiperostosis. ABSTRACTChronic recurrent multifocal osteomyelitis is a sterile autoinflammatory disease characterized by foci of sterile inflammation in the bone that generate recurrent pain. It is a rare entity in which the cardinal clinical manifestation is the presence of inflammatory bone lesions in metaepiphyseal regions of long bones, predominating in lower limbs. The disease is often associated with systemic symptoms and skin involvement making it part of the arthritis-dermatitis syndrome. The most common radiographic finding is osteolysis surrounded by a thin sclerotic halo, without periosteal reaction associated with bone formation or bone sequestrum. Magnetic resonance imaging allows early detection and facilitates the differential diagnosis between osteomyelitis and infections or bone tumors. Treatment is supported mainly by case reports and series of patients and consists of the use of nonsteroidal anti-inflammatory drugs and the use of bisphosphonates or tumor necrosis factor alpha antagonists in refractory cases. The prognosis of this disease is generally good, with a benign and self-limited clinical course in most cases.

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Combination Therapy with Methotrexate and Etanercept for Refractory Chronic Recurrent Multifocal Osteomyelitis: Figure 1.

Cited by 28 publications

References 19 publications

Chronic Recurrent Multifocal Osteomyelitis

Chronic Recurrent Multifocal Osteomyelitis

Autoinflammatory Diseases Predominantly Affecting Bone and Joints

Osteomielitis crónica multifocal recurrente: estado del arte

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