Evidence map›Paper›PMID 34195549›Full record

ArticleMayo Clinic proceedings. Innovations, quality & outcomes2021

Long-term Clinical Outcomes in Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis Syndrome.

Francis H X Yap, Deborah Olsson-White, Janet Roddy, Nicola J Cook, D Robert Langlands, Prue J Manners, Graeme J Carroll

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Mayo Clinic proceedings. Innovations, quality & outcomes, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Chronic Recurrent Multifocal Osteomyelitis: A Review of 80 Cases in Chinese Children.Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases · 2026
    Review
  3. Review
  4. Article
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Francis H X YapPathWest, QEII Medical Centre, Nedlands, Western Australia, Australia.
Deborah Olsson-WhiteDepartment of Rheumatology, QEII Medical Centre, Nedlands, Western Australia, Australia.
Janet RoddyDepartment of Rheumatology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
Nicola J CookWestern Rheumatology, Wyllie Arthritis Foundation, Shenton Park, Western Australia, Australia.
D Robert LanglandsDepartment of Rheumatology, QEII Medical Centre, Nedlands, Western Australia, Australia.
Prue J MannersFaculty of Health and Medical Sciences, University of Western Australia, Nedlands, Western Australia, Australia.
Graeme J CarrollDepartment of Rheumatology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the outcome of empirical therapeutic interventions for synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome.

methodsThe clinical features and treatment outcomes of a cohort of 21 patients diagnosed with SAPHO in Western Australia were reviewed retrospectively.

resultsAll 21 patients met published diagnostic criteria; 20 (95%) were Caucasian, and the median age was 47 years. The median follow-up was 6 years (range, 2 to 32 years). Three patients (14%) received no treatment; 18 (86%) required conventional synthetic disease-modifying antirheumatic drug (DMARDs). Thirteen (62%) had an initial good response to methotrexate; 8 relapsed and progressed to biologic DMARDs (bDMARDs) during a period of 14 years. Of the 13 recipients on a tumor necrosis factor inhibitor, 11 (85%) continued treatment for a median of 4 years (range, 1 to 14 years), whereas none of 3 recipients of interleukin 17/23 continued treatment (median, 4 months). Higher Physician Global Assessment scores (better outcomes) were observed in bDMARD recipients (mean, 7.06±2.24 [SD]) compared with non-bDMARD recipients (mean, 5.63±2.50;

conclusionThis study describes the broad range of clinical manifestations in SAPHO, variable courses over time, and inconsistent outcomes with diverse empirical therapies. Moderately good long-term treatment outcomes were observed in most recipients of tumor necrosis factor inhibitor. Poorer outcomes were observed with bisphosphonates and interleukin 17/23 axis inhibitors; however, low numbers preclude robust comparison. Suboptimal treatment may be associated with poorer clinical outcomes and greater skeletal damage.

trial registrationAustralian and New Zealand Clinical Trials Registry: ACTRN12619000445178.

Indexed as

bDMARD, biologic disease-modifying antirheumatic drugCRP, C-reactive proteinDMARD, disease-modifying antirheumatic drugIL, interleukinMTX, methotrexatePGA, Physician Global AssessmentPPP, palmoplantar pustulosisSAPHO, synovitis, acne, pustulosis, hyperostosis, and osteitisTNF, tumor necrosis factor

Identifiers

PMID34195549
PMCPMC8240170

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LicenceCC BY-NC-ND
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Registered trials

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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.