Extra-osseous manifestations in chronic recurrent multifocal osteomyelitis: a retrospective study

Area of Science:

• Pediatric Rheumatology
• Osteomyelitis Research
• Inflammatory Diseases

Background:

• Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory bone disease.
• Extra-osseous (EO) manifestations in CRMO are not well-defined.
• Characterizing EO events is crucial for understanding CRMO heterogeneity.

Purpose of the Study:

• To determine the frequency and characteristics of EO manifestations in CRMO.
• To investigate treatment patterns for CRMO with EO involvement.
• To identify distinct CRMO phenotypes based on EO manifestations.

Main Methods:

• Multicentre retrospective study of CRMO patients (2015-2022).
• EO manifestations included skin, gastrointestinal, joint, and systemic symptoms.
• Data collected on demographics, clinical features, and treatments.

Main Results:

• EO manifestations occurred in 67.7% of 133 CRMO patients.
• Predominant EO symptoms were skin lesions (56.7%) and sacroiliitis (42.2%).
• Patients with EO manifestations more frequently received biologics (36.7% received TNF inhibitors).

Conclusions:

• CRMO patient cohorts can be delineated into distinct groups based on EO involvement.
• Biologic therapies, particularly TNF inhibitors, show promise in managing CRMO with EO manifestations.
• Further research into CRMO pathophysiology may reveal underlying mechanisms for diverse phenotypes.