New Insights in the Treatment of SAPHO Syndrome and Medication Recommendations

Wei Cheng; Fen Li; Jing Tian; Xi Xie; Jin-Wei Chen; Xiao-Fei Peng; Qi Tang; Yan Ge

doi:10.2147/JIR.S353539

New Insights in the Treatment of SAPHO Syndrome and Medication Recommendations

J Inflamm Res. 2022 Apr 13:15:2365-2380. doi: 10.2147/JIR.S353539. eCollection 2022.

Authors

Wei Cheng¹, Fen Li¹, Jing Tian¹, Xi Xie¹, Jin-Wei Chen¹, Xiao-Fei Peng¹, Qi Tang¹, Yan Ge¹

Affiliation

¹ Department of Rheumatology and Immunology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People's Republic of China.

Abstract

Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome is a rare autoinflammatory disease characterized by dermatological disorders and osteoarticular inflammatory lesions. This article reviews the application of biologics and other treatments based on the therapeutic target and the size of molecules in SAPHO syndrome. We found that drugs, especially biologics, have different effects on bone, joint, and skin damage. This may relate to the different inflammatory pathways involved in the osteoarticular and cutaneous symptoms in SAPHO patients. In this study, we provide stratified medication recommendations for SAPHO syndrome. Patients with osteoarticular symptoms can consider tumor necrosis factor blockers, JAK inhibitor, interleukin (IL)-1 inhibitor, and IL-17 inhibitor. Patients with cutaneous symptoms should consider IL-17 and JAK inhibitors. Apremilast, Tripterygium wilfordii Hook F, and bisphosphonates are other effective treatments.

Keywords: SAPHO; biologics; cutaneous symptoms; immune pathway pathways; osteoarticular symptoms; targeted small molecule compounds.

Publication types

Review

Grants and funding

The study was supported by the National Natural Science Foundation of China (Grant No.81701622) and research grant (2018JJ2588, 2018JJ3724) from the Natural Science Foundation of Hunan Province.