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Efficacy of tofacitinib in synovitis, acne, pustulosis, hyperostosis and osteitis syndrome: a pilot study with clinical and MRI evaluation
  1. Yueting Li1,
  2. Jianwei Huo2,
  3. Yihan Cao3,
  4. Meiyan Yu2,
  5. Yanan Zhang2,
  6. Zhaohui Li4,
  7. Chen Li5,
  8. Wen Zhang1
  1. 1Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
  2. 2Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
  3. 3Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
  4. 4Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
  5. 5Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
  1. Correspondence to Dr Chen Li, Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China; casio1981{at}163.com; Professor Wen Zhang, Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases(NCRC-DID), Beijing, China; zhangwen91{at}sina.com

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Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a chronic inflammatory disease that severely affects patients’ quality of life. Therapies including tumour necrosis factor inhibitors (TNFi) and bisphosphonates (BPs) yield variable efficacy.1 Tofacitinib, a Janus kinase inhibitor, may suppress osteoclast-mediated joint damage by inhibiting the RANKL pathway.2 A previous study proved the safety and efficacy of tofacitinib in psoriatic arthritis resistant to TNFi over 3 months.3 Additionally, we reported a case where tofacitinib in combination with methotrexate and Tripterygium wilfordii Hook was effective in SAPHO syndrome.4

To further explore tofacitinib efficacy in SAPHO syndrome, we retrospectively reviewed the medical records of patients enrolled from January 2019 to December 2019 in our dynamic cohort of SAPHO syndrome.5 Patients were included if they: (1) received tofacitinib without concomitant TNFi, BPs, or other disease-modifying antirheumatic drugs and (2) had complete clinical data and MRI of SAPHO-related lesions with pain before (within 1 week) and during tofacitinib treatment. The pain visual analogue scale (VAS) score and …

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Footnotes

  • Handling editor Josef S Smolen

  • Contributors YL, JH, and YC contributed equally to this work. YL, YC, CL, and WZ participated in the design of the study. CL, MY and YZ contributed to clinical data collection. JH, MY, YZ and YC assessed the MR images. YL, ZL and CL accomplished data analysis. YL, YC, MY, CL and WZ prepared the manuscript.

  • Funding This work was supported by the CAMS Innovation Fund for Medical Sciences (2017-I2M-3-001); the Capital Medical Research and Development Fund (2016-4-40112); and the National Key Research and Development Program of China (2016YFC0901500).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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