Gathering expert consensus to inform a proposed trial in chronic nonbacterial osteomyelitis (CNO)

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • C. M. Hedrich - , University of Liverpool (UOL), Royal Liverpool Children's NHS Trust: (Autor:in)
  • M. W. Beresford - , University of Liverpool (UOL), Royal Liverpool Children's NHS Trust: (Autor:in)
  • F. Dedeoglu - , Harvard University (Autor:in)
  • G. Hahn - , Institut und Poliklinik für diagnostische und interventionelle Radiologie, Technische Universität Dresden (Autor:in)
  • S. R. Hofmann - , Klinik und Poliklinik für Kinder- und Jugendmedizin (Autor:in)
  • A. F. Jansson - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • R. M. Laxer - , University of Toronto (Autor:in)
  • P. Miettunen - , University of Calgary (Autor:in)
  • H. Morbach - , Universitätsklinikum Würzburg (Autor:in)
  • C. E. Pain - , Royal Liverpool Children's NHS Trust: (Autor:in)
  • A. V. Ramanan - , University of Bristol (Autor:in)
  • E. Roberts - , Royal Liverpool Children's NHS Trust: (Autor:in)
  • A. Schnabel - , Klinik und Poliklinik für Kinder- und Jugendmedizin (Autor:in)
  • A. Theos - , Georgetown University (Autor:in)
  • L. Whitty - , University of Liverpool (UOL) (Autor:in)
  • Y. Zhao - , University of Washington (Autor:in)
  • P. J. Ferguson - , University of Iowa (Autor:in)
  • H. J. Girschick - , Vivantes Klinikum im Friedrichshain (Autor:in)

Abstract

Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disease that primarily affects children and adolescents. CNO is associated with pain, bone swelling, deformity, and fractures. Its pathophysiology is characterized by increased inflammasome assembly and imbalanced expression of cytokines. Treatment is currently based on personal experience, case series and resulting expert recommendations. Randomized controlled trials (RCTs) have not been initiated because of the rarity of CNO, expired patent protection of some medications, and the absence of agreed outcome measures. An international group of fourteen CNO experts and two patient/parent representatives was assembled to generate consensus to inform and conduct future RCTs. The exercise delivered consensus inclusion and exclusion criteria, patent protected (excludes TNF inhibitors) treatments of immediate interest (biological DMARDs targeting IL-1 and IL-17), primary (improvement of pain; physician global assessment) and secondary endpoints (improved MRI; improved PedCNO score which includes physician and patient global scores) for future RCTs in CNO.

Details

OriginalspracheEnglisch
Aufsatznummer109344
FachzeitschriftClinical immunology
Jahrgang251
PublikationsstatusVeröffentlicht - Juni 2023
Peer-Review-StatusJa

Externe IDs

PubMed 37098355

Schlagworte

Schlagwörter

  • CNO, CRMO, Consensus, Osteomyelitis, Outcome, Study, Treatment, Trial, Cytokines, Pain/complications, Humans, Osteomyelitis/drug therapy, Adolescent, Antirheumatic Agents/therapeutic use, Child, Chronic Disease