To estimate the incidence and prevalence of chronic non-bacterial osteomyelitis (CNO) in children with childhood-onset inflammatory bowel disease (IBD) and compare it with matched non-IBD children.
Key Findings:
CNO diagnosed in 0.13% of the IBD cohort at diagnosis compared to 0.03% in non-IBD comparators (p-value needed).
During follow-up, the adjusted hazard ratio for developing CNO in IBD patients was 5.87 (95% CI 2.95-11.66).
Prevalence of CNO was 0.48% in IBD patients and 0.02% in matched non-IBD comparators by December 31, 2022.
IBD patients with CNO had a lower median age at IBD diagnosis (11 years) compared to those without CNO (14 years).
Extraintestinal manifestations were more frequent in IBD + CNO patients (62% vs 21%, p-value needed).
Higher usage of biologics was noted in the IBD + CNO group (78% vs 44%, p-value needed).
Interpretation:
Children with IBD have a significantly increased risk of CNO, characterized by younger age at diagnosis and higher rates of extraintestinal manifestations and biologic treatment.
Limitations:
Study limited to the Swedish population, which may affect generalizability to other regions.
Data reliant on accurate reporting in healthcare registers, which may introduce reporting bias.
Conclusion:
Childhood-onset IBD is associated with a six-fold increased risk of developing CNO, underscoring the need for heightened awareness and monitoring of this association in clinical practice.
