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Letter
Successful treatment of SAPHO syndrome with infliximab: report of two cases
  1. I Olivieri1,
  2. A Padula1,
  3. G Ciancio1,
  4. C Salvarani2,
  5. L Niccoli3,
  6. F Cantini3
  1. 1Rheumatology Department of Lucania, S Carlo Hospital of Potenza and Matera Hospital, Potenza and Matera, Italy
  2. 2Rheumatic Disease Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
  3. 3Rheumatic Disease Unit, Prato Hospital, Prato, Italy
  1. Correspondence to:
    Dr I Olivieri, Rheumatology Department of Lucania, San Carlo Hospital, Contrada Macchia Romana, 85100 Potenza, Italy;
    ignazioolivieri{at}tiscalinet.it

https://doi.org/10.1136/ard.61.4.375

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    The treatment of SAPHO syndrome is empirical and has recently been reviewed.1–3 Non-steroidal anti-inflammatory drugs (NSAIDs) are the first choice but have limited efficacy. Second line drugs have been tried with mixed results. Positive effects with pamidronate, which partly works by blocking tumour necrosis factor α, have been reported.3,4 Recently, Maksymowych et al suggested that pamidronate is also effective in spondarthritis, which shares manifestations and clinical associations with the SAPHO syndrome.5,6 Infliximab, a chimeric anti-tumour necrosis factor α monoclonal IgG1 antibody, has recently been proved to be effective in the treatment of ankylosing spondylitis7,8 and psoriatic arthritis.7,9

    CASE REPORTS

    In view of this information we treated two patients affected by refractory SAPHO syndrome with infliximab. Both patients had chest pain limiting normal activity despite adequate treatment with NSAIDs and second line treatment was unsuccessful. Both patients received three intravenous infusions of infliximab (5 mg/kg) at …

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