The following is a summary of “Feasibility of Conducting Comparative Effectiveness Research and Validation of a Clinical Disease Activity Score for Chronic Nonbacterial Osteomyelitis,” published in the October 2023 issue of Rheumatology by Wu et al.

Researchers started a retrospective study to determine the use and safety of consensus treatment plans (CTP) in chronic nonbacterial osteomyelitis (CNO), assess the feasibility of using Chronic Nonbacterial Osteomyelitis International Registry (CHOIR) for comparative effectiveness research (CER), and develop and validate a CNO clinical disease activity score.

They enrolled consenting children or young adults with CNO into CHOIR and collected demographic, clinical, and imaging data. The CNO CDAS was created using Delphi surveys and the nominal group technique, with external validation surveys among CHOIR participants.

The results showed that 140 (78.2%) of CHOIR participants (August 2018 and September 2020) earned at least one CTP regimen. Baseline characteristics in different CTP groups were well matched. Key variables in the CNO CDAS included patient pain, patient global assessment, and clinical CNO lesion count. The CDAS exhibited a strong correlation with patient/parent-reported limb, back, or jaw difficulty and disease severity but a weak correlation with patient/parent-reported fatigue, sadness, and tension. The change in CDAS was standard in patients reporting disease worsening or improvement (P<0.001). CDAS decreased after initiating second-line treatments, from a median of 12.0 (IQR 8.0-15.5) to 5.0 (IQR 3.0-12.0; P=0.002). Second-line therapies were well tolerated, with psoriasis as the adverse event.

They concluded that CNO CDAS was developed and validated to monitor disease activity and assess treatment effectiveness, providing a framework for future CER.

Source: jrheum.org/content/50/10/1333