Differentiated approach to non-bacterial osteomyelitis treatment in children: The retrospective study results

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Abstract

Background: Low efficacy of the therapy of children with non-bacterial osteomyelitis remains a topical problem of modern pediatrics and rheumatology. Objective: Our aim was to assess the efficacy and safety of non-bacterial osteomyelitis treatment in children. Methods. A retrospective study of the case records of children with non-bacterial osteomyelitis has been carried out. The therapy efficacy (remission) was assessed by the following criteria: absence of fever, pain, clinically active lesions, laboratory disease activity. Laboratory and radiological methods were carried out during diagnosis of the pathological process, and subsequently every 3-6-12 months to assess disease activity depending on the initial injury extent of the skeleton. Clinical activity assessment was carried out by means of a visual analogue scale. Results: We analyzed treatment results of 52 children (68 therapy courses) with non-bacterial osteomyelitis. Nonsteroidal anti-inflammatory drugs were administered to 19 patients, sulfasalazine - to 7, methotrexate - to 9, pamidronic acid - to 18, inhibitors of tumour necrosis factor (TNF) α - to 15. Remission was achieved in 10 (53%) 4 (57%) 4 (44%), 16 (89%), and 11 (73%) patients (p = 0.001), respectively. Adverse events during treatment occurred in 21 (40%) children. No serious adverse events were reported. Conclusion: The efficacy of different regimens has been shown. It was found that pamidronic acid drug and TNF α inhibitors were the most effective in treating children with non-bacterial osteomyelitis.

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Kostik, M. M., Kopchak, O. L., Chikova, I. A., Isupova, E. A., Masalova, V. V., Dubko, M. F., … Chasnyk, V. G. (2016). Differentiated approach to non-bacterial osteomyelitis treatment in children: The retrospective study results. Voprosy Sovremennoi Pediatrii - Current Pediatrics, 15(5), 505–512. https://doi.org/10.15690/vsp.v15i5.1625

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