Yongdong Zhao1, Nancy A Chauvin1, Diego Jaramillo1, Jon M Burnham2. 1. From the Pediatric Rheumatology Department, Seattle Children's Hospital, Seattle, Washington; Department of Radiology, and the Division of Pediatric Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.Y. Zhao, MD, PhD, acting assistant professor, Pediatric Rheumatology Department, Seattle Children's Hospital; N.A. Chauvin, MD, Assistant Professor; D. Jaramillo, MD, MPH, Professor, Department of Radiology, The Children's Hospital of Philadelphia; J.M. Burnham, MD, MSCE, Associate Professor, Division of Pediatric Rheumatology, The Children's Hospital of Philadelphia. 2. From the Pediatric Rheumatology Department, Seattle Children's Hospital, Seattle, Washington; Department of Radiology, and the Division of Pediatric Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.Y. Zhao, MD, PhD, acting assistant professor, Pediatric Rheumatology Department, Seattle Children's Hospital; N.A. Chauvin, MD, Assistant Professor; D. Jaramillo, MD, MPH, Professor, Department of Radiology, The Children's Hospital of Philadelphia; J.M. Burnham, MD, MSCE, Associate Professor, Division of Pediatric Rheumatology, The Children's Hospital of Philadelphia. burnhams@email.chop.edu.
Abstract
OBJECTIVE: To retrospectively assess changes in disease activity and skeletal damage in children with chronic nonbacterial osteomyelitis (CNO) after infliximab and methotrexate, with or without zoledronic acid or nonsteroidal antiinflammatory drug (NSAID) monotherapy, using a standardized magnetic resonance imaging (MRI) approach. METHODS: Treatment-related changes in clinical and MRI measures from aggressive therapy and NSAID monotherapy groups (n = 9 per group) were evaluated using nonparametric methods. RESULTS: Pain, physical function, physician global assessment, inflammatory markers, nonvertebral inflammatory lesion number, and maximum bone edema score all improved significantly with aggressive therapy (p < 0.03), whereas only the maximum soft tissue inflammation severity decreased (p = 0.02) with NSAID monotherapy. Vertebral deformities and physeal damage did not worsen in the aggressive therapy group but 1 in the NSAID group had worsening of growth plate damage. CONCLUSION: An aggressive treatment regimen in CNO improved clinical and imaging measures of disease activity without progression of skeletal damage.
OBJECTIVE: To retrospectively assess changes in disease activity and skeletal damage in children with chronic nonbacterial osteomyelitis (CNO) after infliximab and methotrexate, with or without zoledronic acid or nonsteroidal antiinflammatory drug (NSAID) monotherapy, using a standardized magnetic resonance imaging (MRI) approach. METHODS: Treatment-related changes in clinical and MRI measures from aggressive therapy and NSAID monotherapy groups (n = 9 per group) were evaluated using nonparametric methods. RESULTS:Pain, physical function, physician global assessment, inflammatory markers, nonvertebral inflammatory lesion number, and maximum bone edema score all improved significantly with aggressive therapy (p < 0.03), whereas only the maximum soft tissue inflammation severity decreased (p = 0.02) with NSAID monotherapy. Vertebral deformities and physeal damage did not worsen in the aggressive therapy group but 1 in the NSAID group had worsening of growth plate damage. CONCLUSION: An aggressive treatment regimen in CNO improved clinical and imaging measures of disease activity without progression of skeletal damage.
Authors: Yongdong Zhao; Eveline Y Wu; Melissa S Oliver; Ashley M Cooper; Matthew L Basiaga; Sheetal S Vora; Tzielan C Lee; Emily Fox; Gil Amarilyo; Sara M Stern; Jeffrey A Dvergsten; Kathleen A Haines; Kelly A Rouster-Stevens; Karen B Onel; Julie Cherian; Jonathan S Hausmann; Paivi Miettunen; Tania Cellucci; Farzana Nuruzzaman; Angela Taneja; Karyl S Barron; Matthew C Hollander; Sivia K Lapidus; Suzanne C Li; Seza Ozen; Hermann Girschick; Ronald M Laxer; Fatma Dedeoglu; Christian M Hedrich; Polly J Ferguson Journal: Arthritis Care Res (Hoboken) Date: 2018-07-12 Impact factor: 4.794
Authors: Yongdong Zhao; Fatma Dedeoglu; Polly J Ferguson; Sivia K Lapidus; Ronald M Laxer; Miranda C Bradford; Suzanne C Li Journal: Int J Rheumatol Date: 2017-01-10
Authors: Victoria K Shanmugam; Marc Phillpotts; Timothy Brady; Monica Dalal; Shawn Haji-Momenian; Esma Akin; Kavita Nataranjan; Sean McNish; Donald S Karcher Journal: BMC Rheumatol Date: 2019-08-01