Observational studyClinical rheumatology2019
Paradoxical skin lesions induced by anti-TNF-α agents in SAPHO syndrome.
Observational study in Clinical rheumatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Pooled it
- Clinical and therapeutic diversity in adult chronic nonbacterial osteomyelitis (CNO) of the sternocostoclavicular region: a meta-analysis.Rheumatology (Oxford, England) · 2023Pooled it
- Case Report: Upadacitinib for SAPHO syndrome with biologics-induced paradoxical manifestation and Hyperimmunoglobulinemia E.Frontiers in immunology · 2026Article
- Case Report: Rapid improvement with upadacitinib in a case of paradoxical skin lesions associated with SAPHO syndrome.Frontiers in immunology · 2026Article
- Review
- What Is New and What Is Next for SAPHO Syndrome Management: A Narrative Review.Journal of clinical medicine · 2025Review
- Evaluation of tonsillectomy in the treatment of SAPHO syndrome: past evidence and future directions.Frontiers in medicine · 2025Review
- Case Report: Successful treatment of refractory synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome and palmoplantar pustulosis with ustekinumab.Frontiers in immunology · 2025Article
- Therapeutic approaches for SAPHO syndrome from the perspective of pathogenesis: a review of the literature.Frontiers in immunology · 2025Review
- Successful Treatment of Adalimumab-Induced Paradoxical Skin Reactions in Pustulotic Arthro-Osteitis With Guselkumab.Cureus · 2024Article
- Successful Treatment of Refractory Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) Syndrome and Paradoxical Psoriasis with Secukinumab: A Case Report.Clinical, cosmetic and investigational dermatology · 2024Article
- The role of cytokines in the pathogenesis of SAPHO syndrome.Frontiers in immunology · 2024Review
- Successful Treatment of SAPHO Syndrome Complicated with Ankylosing Spondylitis by Secukinumab: A Case Report.Journal of personalized medicine · 2023Article
- New Insights in the Treatment of SAPHO Syndrome and Medication Recommendations.Journal of inflammation research · 2022Review
- Rapid remission of refractory synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome in response to the Janus kinase inhibitor tofacitinib: A case report.World journal of clinical cases · 2020Article
- Successful treatment of synovitis, acne, pustulosis, hyperostosis, and osteitis and paradoxical skin lesions byThe Journal of international medical research · 2020Article
- Demographic, clinical, and scintigraphic comparison of patients affected by palmoplantar pustulosis and severe acne: a retrospective study.Clinical rheumatology · 2020Article
- Synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome: review and update.Therapeutic advances in musculoskeletal disease · 2020Review
- SAPHO: has the time come for tailored therapy?Clinical rheumatology · 2020Review
- SAPHO syndrome with pathological fractures of vertebral bodies: a case report.BMC musculoskeletal disorders · 2019Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
The objectives of the study were to characterize the clinical picture of paradoxical skin lesions in SAPHO patients treated with anti-TNF-α agents and to explore its pathogenesis. Patients treated with anti-TNF-α therapy were identified from a cohort of 164 SAPHO patients. The clinical data and skin biopsies were collected. The usage, efficacy, and side effects of anti-TNF-α therapy were recorded. Forty-one (25.0%) patients received anti-TNF-α therapy, of which seven (17.1%) developed paradoxical skin lesions after 1 to 14 infusions. Patients with such lesions were older at onset of skin lesions than those without (p = 0.034). Expression of TNF-α in palmoplantar pustulosis increased after anti-TNF-α therapy in the two examined patients with exacerbated skin lesions. Anti-TNF-α therapy induces paradoxical skin lesions in 17.1% SAPHO patients. Late onset of skin manifestations is associated with an increased risk of such lesions. The paradoxical elevation of TNF-α expression in lesions may contribute to this phenomenon.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.