Original article
Bisphosphonate Treatment in Chronic Recurrent Multifocal Osteomyelitis

https://doi.org/10.1016/j.jpeds.2007.08.047Get rights and content

Objective

To test the safety and efficacy of biphosphonates in chronic recurrent multifocal osteomyelitis (CRMO).

Study design

Five patients with CRMO, all of whom had ongoing pain and loss of function despite conventional treatment with non-steroidal anti-inflammatory agents, were treated with pamidronate (1 mg/kg/dose with a dosing frequency of 2 to 4 monthly for a total treatment duration of 12 to 42 months).

Results

Pain decreased after the first infusion for 4 of 5 patients, with symptomatic improvement maintained with time. Significant improvement was seen in radiological lesions for these 4 patients.

Conclusion

Bisphosphonates appear to be a useful and safe adjunctive treatment in CRMO when simple therapies such as anti-inflammatory agents fail to control symptoms or cases in which lesion expansion continues.

Section snippets

Case Histories

Clinical details and pamidronate dosing for each patient are summarized in Table I. Radiological changes are summarized in Table II.

Discussion

In this case series of pamidronate use in CRMO, objective evidence of reduction in lesion size has been demonstrated. One earlier case series of children with the related SAPHO syndrome has shown symptomatic improvement only, with no objective change in lesion size.16 Earlier case reports of CRMO have shown response to treatment in individual patients. Four of our 5 patients showed clinical response, with some radiographic changes in all 4 patients. The fifth patient may have had some minimal

References (23)

  • W. Holden et al.

    Chronic recurrent multifocal osteomyelitis: two cases of sacral disease responsive to corticosteroids

    Clin Infect Dis

    (2005)
  • Cited by (89)

    • Chronic Recurrent Multifocal Osteomyelitis

      2024, Medical Clinics of North America
    • Chronic nonbacterial monoarticular osteomyelitis of the elbow

      2022, JSES Reviews, Reports, and Techniques
    View all citing articles on Scopus
    View full text