Ilium osteitis as the main manifestation of the SAPHO syndrome: response to infliximab therapy and review of the literature.

Abstract

OBJECTIVE:

To analyze the clinical efficacy of anti-tumor necrosis factor (TNF)-alpha therapy in the SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome. We describe 2 new cases with ilium osteitis as the main SAPHO syndrome feature and review reported cases treated with anti-TNF-alpha.

METHODS:

A literature search of SAPHO syndrome cases treated with TNF-alpha blocking therapy with special emphasis on osteoarticular and skin responses was performed.

RESULTS:

Eighteen cases were identified: 17 SAPHO syndrome and 1 chronic recurrent multifocal osteomyelitis, a juvenile variant of SAPHO syndrome. Sixteen were reported cases and 2 were nonreported cases seen in our arthritis unit. Sixteen patients received infliximab and 2 received etanercept, with an early, sustained clinical improvement in most cases.

CONCLUSIONS:

Anti-TNF-alpha therapies are effective treatment for patients with refractory SAPHO syndrome, not only for cutaneous lesions but also for persistent bone lesions such as osteitis.

• Authors: Concepción Moll, M Victoria Hernández, Juan D Cañete, José A Gómez-Puerta, Alex Soriano, Antonio Collado, Raimon Sanmartí
• Journal: Seminars in arthritis and rheumatism (Semin Arthritis Rheum) Vol. 37 Issue 5 Pg. 299-306 (Apr 2008) ISSN: 0049-0172 [Print] United States
• PMID: 17976692 (Publication Type: Journal Article, Review)

Chemical References

• Anti-Inflammatory Agents
• Antibodies, Monoclonal
• Tumor Necrosis Factor-alpha
• Infliximab

Topics

• Acquired Hyperostosis Syndrome (complications, diagnosis, drug therapy)
• Anti-Inflammatory Agents (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Diagnosis, Differential
• Humans
• Ilium
• Infliximab
• Osteitis (diagnosis, drug therapy, etiology)
• Treatment Outcome
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)