Chronic recurrent multifocal osteomyelitis

A type of osteomyelitis that occurs in children and is characterized by INFLAMMATION of the bones, especially with lesions at the metaphyses of the long bones; pain, and joint swelling. Patients may or may not present with fever. This disorder may occur alone or together with PSORIASIS or INFLAMMATORY BOWEL DISEASE; may also occur with Majeed Syndrome. OMIM: 259680

Also Known As:

Networked: 143 relevant articles (11 outcomes, 14 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Chronic recurrent multifocal osteomyelitis
2.	Psoriasis (Pustulosis Palmaris et Plantaris)
3.	Bone Resorption
4.	Majeed syndrome
5.	Infections

Experts

1.	Ferguson, Polly J: 8 articles (01/2020 - 04/2012)
2.	Morbach, Henner: 7 articles (08/2021 - 10/2012)
3.	Zhao, Yongdong: 4 articles (11/2022 - 04/2017)
4.	Kanneganti, Thirumala-Devi: 4 articles (01/2020 - 01/2014)
5.	Hedrich, Christian M: 4 articles (01/2019 - 10/2012)
6.	Girschick, Hermann J: 4 articles (12/2017 - 10/2012)
7.	Gurung, Prajwal: 3 articles (01/2020 - 12/2014)
8.	Laxer, Ronald M: 3 articles (11/2019 - 07/2007)
9.	Hedrich, C M: 3 articles (01/2019 - 02/2012)
10.	Hofmann, Sigrun R: 3 articles (12/2017 - 10/2012)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Chronic recurrent multifocal osteomyelitis:

1.	Pamidronate (Aredia)FDA LinkGeneric 01/01/2021 - "After diagnosis of CRMO, two received intravenous pamidronate. " 01/12/2009 - "Four patients had MRI confirmed CRMO recurrence, which responded to one pamidronate re-treatment. " 01/12/2009 - "We report our prospectively documented experience with all CRMO patients treated with pamidronate between 2003 and 2008 at a tertiary pediatric centre. " 01/12/2009 - "We propose that pamidronate is an effective second-line therapy in persistent CRMO." 01/12/2009 - "Our objective is to describe clinical, magnetic resonance imaging (MRI), and bone resorption response to intravenous pamidronate in pediatric CRMO. "
2.	Azithromycin (Zithromax)FDA LinkGeneric 10/01/2000 - "This study will possibly help to answer the question of the additional antiphogistic/immunomodulatory effect of Azithromycin in this disease entity and the related CRMO." 10/01/2000 - "[Azithromycin: an anti-inflammatory effect in chronic recurrent multifocal osteomyelitis? " 10/01/2000 - "In this preliminary communication we report our experience with Azithromycin in patients with Chronic Recurring Multifocal Osteomyelitis (CRMO). " 10/01/2000 - "The immediate therapeutic effect of Azithromycin in patients with CRMO was surprising and lead us to the hypothesis that Azithromycin could have an antiphlogistic in addition to it's antibiotic effect in this disease setting. " 12/01/2013 - "We report a 17-year-old patient with inherited STAT1 deficiency, who was diagnosed with Mycobacterium szulgai chronic multifocal osteomyelitis and responded well to the therapy with ethambutol, rifampicin and azithromycin. "
3.	Ustekinumab (CNTO 1275)FDA Link 09/01/2023 - "Two patients in the study showed clinical improvement with concomitant golimumab and ustekinumab with no reported adverse side effects or increased effects in these patients over a 16-month interval, showing that this combination can be safe and effective for children with CRMO. "
4.	golimumabFDA Link 09/01/2023 - "Patients treated with golimumab showed significant improvement in median physician global assessment for CRMO from 2.00 [1.00-3.00] to 0.00 [0.00-0.25] by the fourth visit (p < 0.001), with median erythrocyte sedimentation rate (ESR) decreasing significantly from 12.00 [6.75-23.75] to 5.00 [3.00-10.00] by the fourth visit (p < 0.05). " 09/01/2023 - "Patients who were diagnosed before 21 years of age and followed up for CRMO at least once after receiving ≥ 3 months of golimumab were included. " 09/01/2023 - "A retrospective chart review was conducted of patients with CRMO who received golimumab in a single center between 01 June, 2018 and 31 December, 2020. " 09/01/2023 - "Golimumab in Children with Chronic Recurrent Multifocal Osteomyelitis: A Case Series and Review of the Literature." 09/01/2023 - "The aim of this study was to determine the efficacy and safety of golimumab, a fully humanized TNFi, in children with CRMO, including those who develop paradoxical psoriasis after exposure to other monoclonal TNFi. "
5.	Diphosphonates (Bisphosphonates)IBA 02/25/2023 - "Intravenous bisphosphonates usage seems to be a good therapeutic option in CRMO paediatric patients with spinal localization of the lesions complicated by compressive fractures. " 01/01/2021 - "TNF-α inhibitors and bisphosphonates have shown to be a well-tolerated and efficient treatment for CRMO providing both symptomatic relief and normalization of bone morphology. " 11/01/2019 - "Treatment of chronic recurrent multifocal osteomyelitis with bisphosphonates in children." 04/01/2008 - "Bisphosphonate treatment in chronic recurrent multifocal osteomyelitis." 12/01/2022 - "Some controversial or troubled issues including the efficacy of perforator flap and fascia flap covering soft tissue, searching exclusive detection methods for the diagnosis of COM and bisphosphonates and biological agents in the treatment of CRMO may lead to the development of the COM field."
6.	Adrenal Cortex Hormones (Corticosteroids)IBA 05/01/2000 - "Chronic recurrent multifocal osteomyelitis showing marked improvement with corticosteroid treatment." 02/15/2005 - "We present 2 patients with cases of chronic recurrent multifocal osteomyelitis affecting the sacrum who responded dramatically to treatment with corticosteroids." 02/15/2005 - "Chronic recurrent multifocal osteomyelitis: two cases of sacral disease responsive to corticosteroids." 01/01/2023 - "Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are usually applied as first-line therapy in CRMO patients; however, some cases require more intensive therapy with second-line agents to control disease activity. " 10/01/2000 - "We conclude that 1) CRMO may adversely affect life for years; 2) proven treatments are unavailable; 3) gastroenterological vasculitis/ Crohn's may be associated with CRMO; 4) MRI is useful for monitoring CRMO; 5) In this patient, G-CSF seemed beneficial initially, but later, vasculitis (possibly Crohn's) manifested, leading to bowel resection; 6) Crohn's disease may have been present for years, masked by corticosteroid, and unmasked by reduction of steroids and use of G-CSF."
7.	SteroidsIBA 01/01/2008 - "Salmon-colored conjunctival lesions may accompany CRMO and respond favorably to systemic steroid therapy." 10/01/2000 - "We conclude that 1) CRMO may adversely affect life for years; 2) proven treatments are unavailable; 3) gastroenterological vasculitis/ Crohn's may be associated with CRMO; 4) MRI is useful for monitoring CRMO; 5) In this patient, G-CSF seemed beneficial initially, but later, vasculitis (possibly Crohn's) manifested, leading to bowel resection; 6) Crohn's disease may have been present for years, masked by corticosteroid, and unmasked by reduction of steroids and use of G-CSF." 01/01/2020 - "The patient failed treatment for presumed JIA and CRMO with nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, methotrexate, and adalimumab. " 01/01/2018 - "We report the cases of 3 children suffering from CRMO who were treated with NSAID, steroid, bisphosphonates and eventually received etanercept and 1 case without vertebral involvement treated with etanercept after NSAID and steroid; all cases showed clinical improvement. "
8.	Prednisolone (Predate)FDA LinkGeneric 09/01/2009 - "The newly proposed diagnosis was chronic, recurrent multilocular osteomyelitis (CRMO), for which treatment was begun with prednisolone and indomethacin. " 05/01/2000 - "Under the assumption of chronic recurrent multifocal osteomyelitis (CRMO), an immunosuppressive therapy with diclofenac and prednisolone was started, which at first brought about complete remission. "
9.	Indomethacin (Indometacin)FDA LinkGeneric 07/01/2007 - "Our observation indicates that indomethacin may be an effective treatment for CRMO." 07/01/2007 - "Successful treatment of chronic recurrent multifocal osteomyelitis with indomethacin: a preliminary report of five cases." 07/01/2007 - "Because indomethacin has been successfully applied in inhibition of ossification and inflammatory processes, we initiated therapy with indomethacin in patients with CRMO. " 09/01/2009 - "The newly proposed diagnosis was chronic, recurrent multilocular osteomyelitis (CRMO), for which treatment was begun with prednisolone and indomethacin. "
10.	Collagen Type I (Type I Collagen)IBA 07/01/2007 - "Both bone-specific alkaline phosphatase (bone formation marker) and pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (bone resorption marker) showed a marked decrease with pamidronate therapy, suggesting that pamidronate is useful for the treatment of chronic recurrent multifocal osteomyelitis with inhibitory effect on bone turnover."

Therapies and Procedures

1.	Therapeutics 08/01/2010 - "Further studies are needed to establish the role of these therapies in refractory CRMO and SAPHO." 12/01/2022 - "Children with complex CRMO more often needed escalation of therapy to DMARDs and biologic agents. " 08/09/2021 - "Knowing the specifics of CNO/CRMO and the importance of MRI/whole-body MRI allows rapid and efficient diagnosis as well as therapy support and helps to avoid irreversible secondary damage." 01/01/2020 - "As cmo disease in mice, the experimental model analogous to human CRMO, is mediated specifically by IL-1β and not by IL-1α, delineating the molecular pathways contributing to pathogenic IL-1β production is crucial to developing targeted therapies. " 01/01/2019 - "By raising awareness of clinical findings suggestive of CRMO, this report may help expedite diagnosis, so patients can be started on anti-inflammatory therapy."
2.	Perforator Flap 12/01/2022 - "Some controversial or troubled issues including the efficacy of perforator flap and fascia flap covering soft tissue, searching exclusive detection methods for the diagnosis of COM and bisphosphonates and biological agents in the treatment of CRMO may lead to the development of the COM field."
3.	Aftercare (After-Treatment) 02/01/2001 - "We present a 10 year old boy with chronic recurrent multifocal osteomyelitis who improved after treatment with naproxen."
4.	Transjugular Intrahepatic Portasystemic Shunt 01/01/2021 - "We present an overview of the clinical and imaging features of CRMO and, through various clinical scenarios, provide tips for tailoring the differential diagnosis based on location and distribution of encountered abnormalities. "
5.	Salvage Therapy 11/10/2021 - "We report a successful application of Crohn disease exclusion diet (CDED) in association with infliximab and methotrexate, as salvage therapy in a child affected by chronic recurrent multifocal osteomyelitis (CRMO) and Crohn disease (CD) resistant to optimized therapy. "