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Efficacy of antibiotic therapy for SAPHO syndrome is lost after its discontinuation: interventional study
Arthritis Research & Therapy, 09/23/09

Assmann G et al. – For the period of application, the antibiotic therapy seems to have controlled the disease. After antibiotics discontinuation however, disease relapse was observed. SAPHO syndrome thus groups with other chronic inflammatory arthropathies with a need of permanent therapy.

Methods

37 patients met the clinical criteria of SAPHO syndrome
21 underwent a needle biopsy of the osteitis lesion; 14 of them showed positive bacteriological cultures for Propionibacterium acnes
30 patients (14 bacteriological positive and 16 without biopsy) treated with antibiotics for 16 weeks
Activity of skin disease and osteitis assessed by physician using a scoring model (from 0 to 6)
Patients completed a health assessment score (HAS, from 0 to 6).
ESR was determined and a MRI (of the osteitis lesion, radiologic activity score from 0 to 2) was performed in week 1 (W1), week 16 (W16), and week 28 (W28, 12 weeks after antibiotics

Results

Twenty-seven patients continued the medication (azithromycin, n=25, 500 mg twice a week, clindamycin, n=1, 300 mg daily, or doxycycline, n=2, 100 mg daily) for 16 weeks
After W16 the scores for MRI , skin activity , osteitis activity , and HAS decreased significantly
Followed by increasing values for MRI scores , skin activity , osteitis activity , and HAS from W16 to W28
Comparison of the scores in W1 and W28 showed no significant differences

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