CHronic Nonbacterial Osteomyelitis International Registry (CHOIR)
Study Details
Study Description
Brief Summary
The objective of the study is to establish a prospective disease registry for chronic recurrent multifocal osteomyelitis (CRMO)/chronic nonbacterial osteomyelitis (CNO) in order to investigate the natural history of the disease and the responses of patients to different clinical managements over 5 years.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
disease modifying anti-rheumatic drug, DMARD
|
Drug: Methotrexate
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
Drug: Sulfasalazine
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
Drug: Leflunomide
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
|
tumor necrosis factor inhibitor, TNFi
|
Drug: Etanercept
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
Drug: Adalimumab
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
Drug: Certolizumab
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
Drug: Infliximab
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
Drug: Golimumab
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
|
bisphosphonate
|
Drug: Pamidronate
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
Drug: Zoledronic acid
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
|
Outcome Measures
Primary Outcome Measures
- The change of CNO disease activity score [3-6 months]
Disease activity score is calculated as the sum of number of clinical lesion count, patient global assessment (0-10), physician global assessment (0-10)
Secondary Outcome Measures
- Total number of CNO lesions on MRI [3-6 months]
The total number of CNO lesions from MRI as previously described (Zhao, et al. J Rheum 2019) will be used to monitor response in a subset
- Safety monitoring [5 years]
Serious adverse events including infections that require IV antibiotics, malignancy, hematological, hepatic, dermatological side effects will be reported
Eligibility Criteria
Criteria
Inclusion Criteria:
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- Age at enrollment is equal to or younger than 21 years of age
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Presence of bone edema on STIR or T2 fat saturation sequence on MRI within 12 weeks of enrollment
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Whole body imaging evaluation (either WB MRI or bone scintigraphy)
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Bone biopsy to exclude infection or malignancy unless bone lesions follow typical distribution or there is IBD, psoriasis, or palmar plantar pustulosis
Exclusion Criteria:
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- History of or current malignancy
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Current infectious osteomyelitis
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Contraindication to the selected treatment agent
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Seattle Children's Hospital | Seattle | Washington | United States | 98105 |
Sponsors and Collaborators
- Seattle Children's Hospital
- Boston Children's Hospital, Boston, MA, USA
- Hospital for Special Surgery, New York City, NY, USA
- Joseph M Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ, USA
- Riley Children's Hospital, Indianapolis, IN, USA
- University of North Carolina, Chapel Hill, NC, USA
- Royal Children's Hospital, Melbourne, Australia
- Hacettepe University, Ankara, Turkey
- Bambino Gesù Children's Hospital, Rome, Italy
- University of British Columbia, Vancouver, BC, Canada
- Meyer Children's Hospital, Florence, Italy
- Mansoura University
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Beck C, Morbach H, Beer M, Stenzel M, Tappe D, Gattenlöhner S, Hofmann U, Raab P, Girschick HJ. Chronic nonbacterial osteomyelitis in childhood: prospective follow-up during the first year of anti-inflammatory treatment. Arthritis Res Ther. 2010;12(2):R74. doi: 10.1186/ar2992.
- Girschick H, Finetti M, Orlando F, Schalm S, Insalaco A, Ganser G, Nielsen S, Herlin T, Koné-Paut I, Martino S, Cattalini M, Anton J, Mohammed Al-Mayouf S, Hofer M, Quartier P, Boros C, Kuemmerle-Deschner J, Pires Marafon D, Alessio M, Schwarz T, Ruperto N, Martini A, Jansson A, Gattorno M; Paediatric Rheumatology International Trials Organisation (PRINTO) and the Eurofever registry. The multifaceted presentation of chronic recurrent multifocal osteomyelitis: a series of 486 cases from the Eurofever international registry. Rheumatology (Oxford). 2018 Jul 1;57(7):1203-1211. doi: 10.1093/rheumatology/key058. Erratum in: Rheumatology (Oxford). 2018 Aug 1;57(8):1504.
- Oliver M, Lee TC, Halpern-Felsher B, Murray E, Schwartz R, Zhao Y; CARRA SVARD CRMO/CNO workgroup. Disease burden and social impact of pediatric chronic nonbacterial osteomyelitis from the patient and family perspective. Pediatr Rheumatol Online J. 2018 Dec 14;16(1):78. doi: 10.1186/s12969-018-0294-1.
- Voit AM, Arnoldi AP, Douis H, Bleisteiner F, Jansson MK, Reiser MF, Weckbach S, Jansson AF. Whole-body Magnetic Resonance Imaging in Chronic Recurrent Multifocal Osteomyelitis: Clinical Longterm Assessment May Underestimate Activity. J Rheumatol. 2015 Aug;42(8):1455-62. doi: 10.3899/jrheum.141026. Epub 2015 May 15.
- Zhao Y, Ferguson PJ. Chronic Nonbacterial Osteomyelitis and Chronic Recurrent Multifocal Osteomyelitis in Children. Pediatr Clin North Am. 2018 Aug;65(4):783-800. doi: 10.1016/j.pcl.2018.04.003. Review.
- Zhao Y, Wu EY, Oliver MS, Cooper AM, Basiaga ML, Vora SS, Lee TC, Fox E, Amarilyo G, Stern SM, Dvergsten JA, Haines KA, Rouster-Stevens KA, Onel KB, Cherian J, Hausmann JS, Miettunen P, Cellucci T, Nuruzzaman F, Taneja A, Barron KS, Hollander MC, Lapidus SK, Li SC, Ozen S, Girschick H, Laxer RM, Dedeoglu F, Hedrich CM, Ferguson PJ; Chronic Nonbacterial Osteomyelitis/Chronic Recurrent Multifocal Osteomyelitis Study Group and the Childhood Arthritis and Rheumatology Research Alliance Scleroderma, Vasculitis, Autoinflammatory and Rare Diseases Subcommittee. Consensus Treatment Plans for Chronic Nonbacterial Osteomyelitis Refractory to Nonsteroidal Antiinflammatory Drugs and/or With Active Spinal Lesions. Arthritis Care Res (Hoboken). 2018 Aug;70(8):1228-1237. doi: 10.1002/acr.23462. Epub 2018 Jul 12. Review.
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