Evidence map›Paper›PMID 40361097›Full record

Observational studyPediatric rheumatology online journal2025

Chronic non-bacterial osteomyelitis in children- five-year standardized follow-up of a prospective observational cohort in the pre-biological era.

Christine Hofmann, Annette Holl-Wieden, Christiane Reiser, Meinrad Beer, Peter Raab, Henner Morbach, Hermann J Girschick

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Pediatric rheumatology online journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Article
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  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Christine HofmannPediatric Rheumatology, Immunology, Osteology, Children's Hospital, University of Wuerzburg, Wuerzburg, Germany. hofmann_c5@ukw.de.
Annette Holl-WiedenPediatric Rheumatology, Immunology, Osteology, Children's Hospital, University of Wuerzburg, Wuerzburg, Germany.
Christiane ReiserClinic of Pediatric Rheumatology and Rare diseases, Children's Hospital, University of Tuebingen, Tuebingen, Germany.
Meinrad BeerDepartment of Radiology, University of Ulm, Ulm, Germany.
Peter RaabSection of Pediatric Orthopedics, University of Wuerzburg, Wuerzburg, Germany.
Henner MorbachPediatric Rheumatology, Immunology, Osteology, Children's Hospital, University of Wuerzburg, Wuerzburg, Germany.
Hermann J GirschickPediatric Rheumatology, Immunology, Osteology, Children's Hospital, University of Wuerzburg, Wuerzburg, Germany.ORCID http://orcid.org/0000-0002-2755-3129

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis prospective, long-term observational study, initiated in 2002, aimed to characterize clinical and laboratory data, whole body MRI detected lesions, and treatment responses in 37 juvenile patients with chronic non-bacterial osteomyelitis at a time when biological DMARDs were not yet standard therapy.

methodsPatients were assessed at baseline and at 1 (without MRI), 3, 6, 12, 18, 24, 36, 48, 60 months. All patients received naproxen as first-line therapy. Clinical management allowed for escalation to sulfasalazine, pamidronate, and glucocorticoids as needed. Treatment response was evaluated using the pedCNO disease activity score (30/50/70/90% improvement). Further composite numeric disease activity (DA) scores- the CARRA CDAS and a new MRI DAS - were applied.

resultsThe mean age at disease onset was 10.8 years, with a diagnostic delay of 5.8 months. Naproxen was the initial treatment in all patients. Second-line therapy was initiated in 10 patients due to inadequate improvement in physician global assessment of disease activity, patient-reported overall wellbeing or MRI lesions. Escalated therapies included sulfasalazine (n = 10), bisphosphonates (n = 1), methotrexate (n = 1), and short- (< 4 wks) or long-term oral glucocorticoids (n = 5 and n = 3, respectively). The mean number of clinical lesions decreased from 2.1 to 0.4 at 12 months and reached 0.15 at 60 months. MRI-detected lesions declined from 5.0 to 2.25 at 12 months and to 1.1 at 60 months.

conclusionMost children experienced favourable long-term outcomes. Clinical improvement occurred more rapidly than radiologic resolution. Patients with insufficient response to NSAIDs should be considered for a treat-to-target approach, including the use of conventional and biologic DMARDs.

trial registrationA trial registration EUDRA CT was not available at the time the study was started. Informed consent was given by all parents.

Indexed as

Antirheumatic AgentsOsteomyelitisAdolescentAnti-Inflammatory Agents, Non-SteroidalChildChild, PreschoolChronic DiseaseFemaleFollow-Up StudiesGlucocorticoidsHumansMagnetic Resonance ImagingMaleNaproxenPamidronateProspective StudiesAnti-Inflammatory Agents, Non-SteroidalAntirheumatic AgentsGlucocorticoidsNaproxenPamidronateSulfasalazineCNOComposite disease activity measuresControlled follow-upCRMOInactive diseaseOsteitisOsteomyelitisOutcomePedCNORemission

Identifiers

PMID40361097
PMCPMC12076821

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.