SynthesisRMD open2023
Treatment and monitoring of SAPHO syndrome: a systematic review.
Synthesis in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled 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.
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
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- [Diagnosis and treatment of chronic nonbacterial osteitis (CNO) and SAPHO syndrome : Implications of the current consensus recommendations of an international commission of experts for German rheumatology].Zeitschrift fur Rheumatologie · 2026Guideline
- Review
- Long-term Evaluation of Mandibular Reconstruction with Fibular Flap in SAPHO Syndrome: 18 Years Post-onset.Journal of plastic and reconstructive surgery · 2026Article
- How Organ Manifestations Beyond the Bone May Guide Risk Stratification and Treatment Decisions in Chronic Nonbacterial Osteomyelitis.Paediatric drugs · 2026Review
- Purely osteolytic bone lesions in the early osteoarticular phase of synovitis, acne, pustulosis, hyperostosis and osteitis syndrome.BMJ case reports · 2026Article
- Case Report: Successful Treatment With Apremilast of SAPHO Syndrome and Refractory Pain.International journal of rheumatic diseases · 2026Article
- Costovertebral joint involvement on CT in SAPHO syndrome: distribution and clinical associations.Skeletal radiology · 2026Article
- CT and MRI features of SAPHO syndrome: a report of 6 cases.BMC musculoskeletal disorders · 2026Article
- Whole-body magnetic resonance imaging in rheumatology: advancements, key applications and future perspectives.La Radiologia medica · 2026Review
- [Inflammatory dermatosis in adult chronic non-bacterial osteomyelitis (adult CNO) from a dermatological perspective].Zeitschrift fur Rheumatologie · 2026Article
- [Treatment of adult chronic non-bacterial osteitis in Germany : Comparison of real-world practice and current expert consensus recommendations].Zeitschrift fur Rheumatologie · 2026Observational
- Prolonged remission of SAPHO syndrome with low-dose leflunomide: A case report and literature review.Experimental and therapeutic medicine · 2026Article
- From misdiagnosis to definitive diagnosis of SAPHO syndrome during a routine health check-up: a case report and literature review.Frontiers in medicine · 2026Article
- Article
- Case Report: Upadacitinib for SAPHO syndrome with biologics-induced paradoxical manifestation and Hyperimmunoglobulinemia E.Frontiers in immunology · 2026Article
- Expanding horizons: radiolabeled FAPI in imaging of autoimmune diseases.Frontiers in immunology · 2026Review
- Targeting the JAK/STAT pathway in palmoplantar pustulosis: a review.Annals of medicine · 2025Review
- Analysis of Potential Subtypes of SAPHO Syndrome.Journal of clinical medicine · 2025Article
- Synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome, neurogenic thoracic outlet syndrome, andJSES reviews, reports, and techniques · 2025Article
- JAK Inhibitors for Treatment of SAPHO Syndrome: A Systematic Review of 72 Cases.ACR open rheumatology · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesSynovitis acne pustulosis hyperostosis osteitis (SAPHO) is a rare heterogeneous disease of unknown aetiopathology. Externally validated and internationally agreed diagnostic criteria or outcomes and, as a result, prospective randomised controlled trials in SAPHO are absent. Consequently, there is no agreed treatment standard. This study aimed to systematically collate and discuss treatment options in SAPHO.
methodsFollowing 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' guidance, a systematic literature search was conducted using PubMed, Scopus and Web of Science databases. Prospective clinical studies and retrospective case collections discussing management and outcomes in SAPHO involving five or more participants were included. Articles not published in English, studies not reporting defined outcomes, and studies solely relying on patient-reported outcomes were excluded.
resultsA total of 28 studies (20 observational, 8 open-label clinical studies) reporting 796 patients of predominantly European ethnicity were included. Reported therapies varied greatly, with many centres using multiple treatments in parallel. Most patients (37.1%) received non-steroidal anti-inflammatory drugs alone or in combination. Bisphosphonates (22.1%), conventional (21.7%) and biological (11.3%) disease-modifying antirheumatic drugs were the next most frequently reported treatments. Reported outcomes varied and delivered mixed results, which complicates comparisons. Bisphosphonates demonstrated the most consistent improvement of osteoarticular symptoms and were associated with transient influenza-like symptoms. Paradoxical skin reactions were reported in patients treated with TNF inhibitors, but no serious adverse events were recorded. Most treatments had limited or mixed effects on cutaneous involvement. A recent study investigating the Janus kinase inhibitor tofacitinib delivered promising results in relation to skin and nail involvement.
conclusionsNo single currently available treatment option sufficiently addresses all SAPHO-associated symptoms. Variable, sometimes descriptive outcomes and the use of treatment combinations complicate conclusions and treatment recommendations. Randomised clinical trials are necessary to generate reliable evidence.
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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.