35例难治性SAPHO综合征患者应用肿瘤坏死因子α拮抗剂的治疗随访

doi:10.3969/j.issn.1004-583X.2016.01.011

临床荟萃 ›› 2016, Vol. 31 ›› Issue (1): 45-47.doi: 10.3969/j.issn.1004-583X.2016.01.011

35例难治性SAPHO综合征患者应用肿瘤坏死因子α拮抗剂的治疗随访

李忱^a, 王景^a, 史小虎^a, 刘晋河^a, 郝伟欣^a, 董振华^a, 张文^b

中国医学科学院北京协和医学院北京协和医院 a.中医科; b.免疫科,北京 100730

收稿日期:2015-09-09 出版日期:2016-01-05 发布日期:2016-04-19
通讯作者: 郝伟欣,Email:wxhao@sina.com;张文,Email:zhangwen91@sina.com

Follow-up of treatment of anti-tumor necrosis factor alpha blocker in 35 patients with refractory SAPHO syndrome

Li Chen^a, Wang Jing^a, Shi Xiaohu^a, Liu Jinhe^a, Hao Weixin^a, Dong Zhenhua^a, Zhang Wen^b

a. Department of Traditional Chinese Medicine; b.Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China

Received:2015-09-09 Online:2016-01-05 Published:2016-04-19
Contact: Hao Weixin, Email: wxhao@sina.com; Zhang Wen, Email: zhangwen91@sina.com

摘要/Abstract

摘要： 目的探讨肿瘤坏死因子α(TNF-α)拮抗剂治疗难治性SAPHO综合征(synovitis, acne, pustulosis, hyperostosisand and osteitis)的疗效及安全性。方法回顾分析35例难治性SAPHO综合征患者使用TNF-α拮抗剂治疗情况,记录患者治疗的反应。结果 35例患者应用TNF-α拮抗剂治疗时间为2～240周,平均(24.4±48.8)周。初期对骨痛有明显改善32例(91.4%),其中接受1次治疗后骨痛有改善22例(68.8%);接受2次治疗后骨痛改善8例(32.0%);接受3次治疗后骨痛改善2例(6.2%)。初期对皮疹有效15例,但在维持治疗中因停药或减量皮疹复发或加重6例;对皮疹无改善12例;出现新发皮疹6例。出现不良反应9例:出现新发皮疹6例、出现颌下腺炎1例、出现臀部脓肿1例、出现肺炎1例。结论难治性SAPHO综合征患者接受TNF-α拮抗剂治疗,初期对骨痛有明显改善32例(91.4%),多在前3次治疗中起效;但维持用药中只有11例(31.4%)有效;对皮疹的改善多不满意,只有9例(27.2%)有效,并且有可能诱发新发皮疹或皮疹加重,同时存在潜在感染的风险。

关键词: 获得性骨肥大综合征, 肿瘤坏死因子α, 治疗结果, 疹

Abstract: Objective To investigate the efficacy and safety of anti-tumor necrosis factor alpha (TNF-α) antagonist in the treatment of refractory SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis).Methods A total of 35 patients with refractory SAPHO syndrome treated by TNF-α antagonist was retrospectively studied and the response of patients was recorded.Results The treatment time for 35 patients with TNF-α antagonist was 2 weeks to 240 weeks, and the average time was (24.4±48.8) weeks. The ostalgia in 32 cases (91.4%) significantly improved in the early time: the ostalgia in 22 cases (68.8%) has been improved after receiving once therapy; the ostalgia in 8 cases (32.0%) improved after receiving twice therapy; the ostalgia in 2 cases (6.2%) improved after receiving therapy three times. For rash, 15 cases were effective in early stage, but in the maintenance treatment, 6 cases had a relapse or aggravation of skin rash and 12 cases had no improvement. A total of 9 cases had adverse reactions: 6 cases had new rash, 1 case had submaxillaritis, 1 case had buttock abscess and 1 case had pneumonia.Conclusion Among the patients with refractory SAPHO syndrome receiving TNF-α antagonist treatment, 91.4% of patients with ostalgia significantly improved in the early time and the improvement was more effective in the first three therapy; but in the maintenance medication, only 11 cases (31.4%) were effective. The improvement of the rash was not wholly satisfied, only 9 cases (27.2%) were effective and it was possible to induce a new or aggravated rash, and also there was potential risk to be infected.

Key words: acquired hyperostosis syndrome, tumor necrosis factor-alpha, treatment outcome, exanthema

中图分类号:

R681.3

李忱, 王景, 史小虎, 刘晋河, 郝伟欣, 董振华, 张文. 35例难治性SAPHO综合征患者应用肿瘤坏死因子α拮抗剂的治疗随访[J]. 临床荟萃, 2016, 31(1): 45-47.

Li Chen, Wang Jing, Shi Xiaohu, Liu Jinhe, Hao Weixin, Dong Zhenhua, Zhang Wen. Follow-up of treatment of anti-tumor necrosis factor alpha blocker in 35 patients with refractory SAPHO syndrome[J]. Clinical Focus, 2016, 31(1): 45-47.

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https://huicui.hebmu.edu.cn/CN/Y2016/V31/I1/45

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35例难治性SAPHO综合征患者应用肿瘤坏死因子α拮抗剂的治疗随访

Follow-up of treatment of anti-tumor necrosis factor alpha blocker in 35 patients with refractory SAPHO syndrome

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