Efficacy of antibiotic therapy for SAPHO syndrome is lost after its discontinuation: an interventional study.
Abstract | INTRODUCTION: METHODS: Thirty-seven patients met the clinical criteria of SAPHO syndrome, 21 of them underwent a needle biopsy of the osteitis lesion, and 14 of them showed positive bacteriological cultures for P. acnes. Thirty patients (14 bacteriological positive and 16 without biopsy) were treated with antibiotics for 16 weeks. The activity of skin disease and osteitis were assessed by a physician using a scoring model (from 0 to 6). In addition, patients completed a Health Assessment Score (HAS, from 0 to 6). The erythrocyte sedimentation rate was determined and a MRI (of the osteitis lesion, radiologic activity score from 0 to 2) was performed in week 1 (W1), week 16 (W16), and week 28 (W28, 12 weeks after antibiotics). RESULTS: Twenty-seven patients continued the medication ( azithromycin, n = 25, 500 mg twice a week; clindamycin, n = 1, 300 mg daily; or doxycycline, n = 1, 100 mg daily) for 16 weeks. After W16 the scores for MRI (1.5 to 1.1, P = 0.01), skin activity (3.2 to 1.2, P = 0.01), osteitis activity (4.0 to 2.1, P = 0.02), and HAS (3.3 to 2.1, P = 0.01) decreased significantly. However, this was followed by increasing values for MRI scores (1.2 to 1.4, P = 0.08), skin activity (1.2 to 1.7, P = 0.11), osteitis activity (1.9 to 2.7, P = 0.01), and HAS (2.2 to 3.3, P = 0.02) from W16 to W28. The comparison of the scores in W1 and W28 in these 12 patients showed no significant differences. CONCLUSIONS:
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Authors | Gunter Assmann, Olaf Kueck, Timm Kirchhoff, Herbert Rosenthal, Jan Voswinkel, Michael Pfreundschuh, Henning Zeidler, Annette D Wagner |
Journal | Arthritis research & therapy
(Arthritis Res Ther)
Vol. 11
Issue 5
Pg. R140
(Oct 09 2009)
ISSN: 1478-6362 [Electronic] England |
PMID | 19772564
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Clindamycin
- Azithromycin
- Doxycycline
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Topics |
- Acquired Hyperostosis Syndrome
(drug therapy, microbiology)
- Adult
- Aged
- Anti-Bacterial Agents
(therapeutic use)
- Azithromycin
(therapeutic use)
- Clindamycin
(therapeutic use)
- Doxycycline
(therapeutic use)
- Female
- Gram-Positive Bacterial Infections
(complications, drug therapy)
- Humans
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Propionibacterium acnes
- Treatment Outcome
- Young Adult
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