Abstract
AbstractChronic non-bacterial osteomyelitis (CNO) is an autoinflammatory, osteolytic bone disorder sometimes localized to a unifocal site in the jaw, causing long-term pain and reduced function. The aim of this study was to describe the patients with CNO of the jaw, focusing on treatment with zoledronic acid for pain relief. An analysis of medical records of 24 patients with CNO of the jaw, including treatment with zoledronic acid and effects on pain relief. Descriptive statistics and nonparametric tests were used to describe the population and compare treatment effects, respectively. The average treatment period was 33.4 months (median 23; Q1 11.5; Q3 42.0) with an average of 4.1 infusions (median 3; Q1 2; Q3 5) of zoledronic acid. The average pain VAS score (visual analogue scale) was significantly reduced from 7.7 (median 8; Q1 6.5; Q3 8.5) to 2.5 points (median 2; Q1 0.5; Q3 4.5) (p < 0.001). At final visit, 46% of patients reported no pain and 38% reported a reduction of pain. At least 67% of patients had at least one episode of pain recurrence, and most patients experienced the first recurrence within a year of initial treatment. Four patients (16%) had no pain relief from the treatment. In this group of patients with CNO of the jaw, there was a positive response to treatment with zoledronic acid on pain relief, averaging 5.2 points on a pain VAS score, with 84% of patients treated experiencing either a partial or a total reduction in pain after about 2.5 years.
Funder
Royal Library, Copenhagen University Library
Publisher
Springer Science and Business Media LLC
Subject
Endocrinology,Orthopedics and Sports Medicine,Endocrinology, Diabetes and Metabolism
Reference18 articles.
1. Buch K, Thuesen ACB, Brøns C, Schwarz P (2019) Chronic non-bacterial osteomyelitis: a review. Calcif Tissue Int 104(5):544–553
2. Bjrkstén B, Boquist L (1980) Histopathological aspects of chronic recurrent multifocal osteomyelitis. J Bone Joint Surg Br 62(3):376–80
3. Gikas PD, Islam L, Aston W, Tirabosco R, Saifuddin A, Briggs TWR et al (2009) Nonbacterial osteitis: a clinical, histopathological, and imaging study with a proposal for protocol-based management of patients with this diagnosis. J Orthop Sci Off J Jpn Orthop Assoc 14(5):505–516
4. Jansson A, Renner ED, Ramser J, Mayer A, Haban M, Meindl A et al (2007) Classification of non-bacterial osteitis: retrospective study of clinical, immunological and genetic aspects in 89 patients. Rheumatol Oxf Engl 46(1):154–160
5. Leclair N, Thörmer G, Sorge I, Ritter L, Schuster V, Hirsch FW (2016) Whole-body diffusion-weighted imaging in chronic recurrent multifocal osteomyelitis in children. PloS one 11(1):e0147523