Abstract | OBJECTIVE: To evaluate the efficacy of intravenous (i.v.) pamidronate in patients with SAPHO syndrome refractory to first line treatments and to review the available literature on pamidronate for this indication. METHODS: We report 14 cases of SAPHO syndrome refractory to non-steroideal anti-inflammatory drugs ( NSAIDs), glucocorticoids and disease modifying anti-rheumatic drugs (DMARDs) treated with i.v. pamidronate. All patients received i.v. 60 mg pamidronate/day for 3 consecutive days. The primary evaluation criterion was the disappearance of bone pain, considered as the reduction in the visual analogic scale for pain (VAS) greater than 50%. RESULTS: Ten patients were females and 4 were males. The mean age at onset was 40.4 years old. Ten patients presented a relapsing-remitting course, while in 4 cases the disease followed a prolonged course. In all cases anterior chest wall involvement occurred early in the disease. In 2 cases there was also a peripheral monoarthritis. Eleven patients experienced several flares of palmo-plantar pustulosis, while severe acne was present in 2. In one case there was no cutaneous involvement. Twelve of the 14 patients had a good response after 3 infusions and in 8 of these patients a sustained remission was observed. The recurrence of skin manifestations does not seem to be influenced by pamidronate. CONCLUSIONS:
Pamidronate appears to be an effective treatment in the osteo-articular manifestations of SAPHO syndrome. As far as cutaneous lesions are concerned, evidence of efficacy is not so impressive.
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Authors | M Colina, R La Corte, F Trotta |
Journal | Clinical and experimental rheumatology
(Clin Exp Rheumatol)
2009 Jan-Feb
Vol. 27
Issue 1
Pg. 112-5
ISSN: 0392-856X [Print] Italy |
PMID | 19327238
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
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Chemical References |
- Bone Density Conservation Agents
- Diphosphonates
- Pamidronate
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Topics |
- Acquired Hyperostosis Syndrome
(drug therapy)
- Adult
- Bone Density Conservation Agents
(therapeutic use)
- Diphosphonates
(therapeutic use)
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Pain
(drug therapy)
- Pamidronate
- Treatment Outcome
- Young Adult
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