Successful treatment of hip involvement in SAPHO syndrome with baricitinib

Wu, Riliga; Wu, Xia; Cao, Yihan; Li, Chen

doi:10.1093/rap/rkac084

Cited by 5 publications

(3 citation statements)

References 2 publications

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“…In one case series with five patients, four exhibited varying degrees of remission in clinical symptoms and laboratory indices after 12 weeks of treatment, whereas one patient showed no significant improvement. [29][30][31][32] Our patient experienced a significant and rapid response after two weeks of oral administration of baricitinib, a selective JAK inhibitor targeting JAK1 and JAK2. Common adverse reactions, including infection, anemia, platelet elevation, leukopenia, and cholesterol elevation, were considered during the course of use.…”

Section: Discussionmentioning

confidence: 85%

Successful Treatment of Refractory Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) Syndrome with Baricitinib, a Janus Kinase Inhibitor

Yang,

Yuan,

Zhou

et al. 2024

CCID

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Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, a rare immune-mediated inflammatory disease, poses diagnostic and therapeutic challenges owing to its multi-system involvement, high heterogeneity, and lack of specific laboratory tests. Additionally, lacking evidence-based treatment recommendations, with the primary approach focusing on symptomatic relief. Herein, we report the case of a 32-year-old Chinese woman who presented with recurrent, generalized multiple osteoarticular pain lasting over one year and skin erythema pustulosis for 11 months. Traditional treatments, including non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and other traditional approaches, yielded no significant effects. Despite the prior use of adalimumab and acitretin capsules, the treatment remained unsatisfying, especially regarding the skin lesions. Considering the complex pathogenesis of SAPHO syndrome, the patient was orally administered baricitinib (2 mg), a Janus kinase (JAK) inhibitor, twice daily. A notable improvement in both skin lesions and osteoarticular pain was observed within two weeks of treatment initiation. Subsequently, the dosage of baricitinib was halved and continued for an additional three months, during which regular follow-ups revealed neither disease recurrence nor adverse effects. Collectively, the successful treatment of refractory SAPHO syndrome with baricitinib presents a promising implication for addressing the therapeutic challenges of this rare autoimmune condition, offering a potential breakthrough in managing its complex manifestations.

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Section: Discussionmentioning

confidence: 85%

Successful Treatment of Refractory Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) Syndrome with Baricitinib, a Janus Kinase Inhibitor

Yang,

Yuan,

Zhou

et al. 2024

CCID

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“…After 12 weeks of monotherapy with baricitinib, all patients showed varying degrees of improvement in clinical scores and laboratory indicators, with no reported adverse reactions during follow-up. 14 It was also found that baricitinib treatment resulted in remission of osteomyelitis visible on MRI.…”

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confidence: 96%

JAKi: Can it be used to treat SAPHO syndrome?

Yue,

Ma,

Liu

et al. 2023

Int J of Rheum Dis

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Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome is a rare autoinflammatory disease characterized by skin and skeletal manifestations with a recurrent-relapsing pattern. 1 Skeletal involvement in SAPHO syndrome presents as aseptic osteomyelitis, while skin involvement is marked by local infiltration of neutrophils. During disease flares, inflammatory markers which mediate inflammation in SAPHO are elevated. As an important intracellular transduction mediator, Janus kinase (JAK) can transmit signals and transport them

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“…), making the diagnosis is often challenging. The hip is a rare site of involvement in SAPHO syndrome, with a prevalence of only 3% [ 6 ].…”

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confidence: 99%