SAPHO: has the time come for tailored therapy?

Clin Rheumatol. 2020 Jan;39(1):177-187. doi: 10.1007/s10067-019-04675-2. Epub 2019 Jul 16.

Abstract

SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome is a heterogeneous condition combining osteoarticular and cutaneous manifestations. Conventional treatments are mostly ineffective. We hereby report two patients, the first with an aggressive form of disease and the second with an incomplete response to two different anti-TNF-α agents. Both were successfully treated with tocilizumab and ustekinumab, respectively, over a long period of time. A narrative review of a biological therapy in SAPHO syndrome yielded very little information on the specific use of these agents. We highlight the advantages of personalising therapy and describe emerging promising treatments for this disease.

Keywords: Anti-IL-1 agents; Anti-IL-12/IL-23 agents; Anti-IL-6 agents; Anti-TNF-α agents; SAPHO syndrome; Treatment.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acquired Hyperostosis Syndrome / diagnosis*
  • Acquired Hyperostosis Syndrome / drug therapy*
  • Acquired Hyperostosis Syndrome / immunology
  • Adult
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Bone and Bones / diagnostic imaging*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Radionuclide Imaging
  • Treatment Outcome
  • Tumor Necrosis Factor Inhibitors / therapeutic use*
  • Ustekinumab / therapeutic use

Substances

  • Antibodies, Monoclonal, Humanized
  • Tumor Necrosis Factor Inhibitors
  • Ustekinumab
  • tocilizumab