Long-term Clinical Outcomes in Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis Syndrome
| Autor: | Graeme J Carroll, Janet Roddy, Deborah Olsson-White, Francis H.X. Yap, Prue J. Manners, D. Robert Langlands, Nicola J. Cook |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Hyperostosis
medicine.medical_specialty Medicine (General) bDMARD biologic disease-modifying antirheumatic drug medicine.medical_treatment 030204 cardiovascular system & hematology 03 medical and health sciences SAPHO synovitis acne pustulosis hyperostosis and osteitis 0302 clinical medicine R5-920 Synovitis Internal medicine Medicine 030212 general & internal medicine Disease-modifying antirheumatic drug MTX methotrexate Acne DMARD disease-modifying antirheumatic drug TNF tumor necrosis factor business.industry medicine.disease Pustulosis PPP palmoplantar pustulosis IL interleukin Clinical trial Cohort CRP C-reactive protein PGA Physician Global Assessment Original Article Osteitis medicine.symptom business |
| Zdroj: | Mayo Clinic Proceedings: Innovations, Quality & Outcomes, Vol 5, Iss 3, Pp 574-582 (2021) Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| ISSN: | 2542-4548 1261-9000 |
| Popis: | Objective To assess the outcome of empirical therapeutic interventions for synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome. Methods The clinical features and treatment outcomes of a cohort of 21 patients diagnosed with SAPHO in Western Australia were reviewed retrospectively. Results All 21 patients met published diagnostic criteria; 20 (95%) were Caucasian, and the median age was 47 years. The median follow-up was 6 years (range, 2 to 32 years). Three patients (14%) received no treatment; 18 (86%) required conventional synthetic disease-modifying antirheumatic drug (DMARDs). Thirteen (62%) had an initial good response to methotrexate; 8 relapsed and progressed to biologic DMARDs (bDMARDs) during a period of 14 years. Of the 13 recipients on a tumor necrosis factor inhibitor, 11 (85%) continued treatment for a median of 4 years (range, 1 to 14 years), whereas none of 3 recipients of interleukin 17/23 continued treatment (median, 4 months). Higher Physician Global Assessment scores (better outcomes) were observed in bDMARD recipients (mean, 7.06±2.24 [SD]) compared with non-bDMARD recipients (mean, 5.63±2.50; P=.1672) after a median of 3 years of therapy. Conclusion This study describes the broad range of clinical manifestations in SAPHO, variable courses over time, and inconsistent outcomes with diverse empirical therapies. Moderately good long-term treatment outcomes were observed in most recipients of tumor necrosis factor inhibitor. Poorer outcomes were observed with bisphosphonates and interleukin 17/23 axis inhibitors; however, low numbers preclude robust comparison. Suboptimal treatment may be associated with poorer clinical outcomes and greater skeletal damage. Trial Registration Australian and New Zealand Clinical Trials Registry: ACTRN12619000445178 |
| Databáze: | OpenAIRE |
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