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Construction of Synthetic Phage Displayed Fab Library with Tailored Diversity
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SAPHO: has the time come for tailored therapy?

Adelaide Sofia Batalha Figueiredo1,2, Ana Luísa Oliveira3,4, António Caetano5

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Clinical Rheumatology
|July 18, 2019
PubMed
Summary

SAPHO syndrome, a condition with bone and skin issues, often resists standard treatments. This study shows successful long-term management using tocilizumab and ustekinumab in two challenging cases.

Keywords:
Anti-IL-1 agentsAnti-IL-12/IL-23 agentsAnti-IL-6 agentsAnti-TNF-α agentsSAPHO syndromeTreatment

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Area of Science:

  • Rheumatology
  • Dermatology
  • Immunology

Background:

  • SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome presents complex osteoarticular and skin symptoms.
  • Existing treatments for SAPHO syndrome often yield limited efficacy.
  • Biological therapies are emerging as potential options for refractory cases.

Observation:

  • Two patients with severe or treatment-resistant SAPHO syndrome were studied.
  • One patient had an aggressive disease form, while the other showed incomplete response to anti-TNF-α agents.
  • Both patients received long-term treatment with specific biologic agents.

Findings:

  • Tocilizumab demonstrated long-term success in a patient with aggressive SAPHO syndrome.
  • Ustekinumab provided sustained therapeutic benefit for a patient with incomplete response to anti-TNF-α therapy.
  • These findings suggest efficacy of IL-6 and IL-12/23 inhibition in SAPHO syndrome.

Implications:

  • Personalized biologic therapy offers a promising strategy for managing refractory SAPHO syndrome.
  • Tocilizumab and ustekinumab represent valuable therapeutic options for SAPHO syndrome patients.
  • Further research into biologic agents is warranted to optimize treatment paradigms for SAPHO syndrome.