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This article explores the potential use of Janus kinase inhibitors (JAKi) in treating SAPHO syndrome, a rare autoinflammatory disease that affects the skin and skeletal system. JAKi can block the action of various cytokines involved in inflammation, making them potentially more effective than biologics that only target one cytokine. The article presents case reports of SAPHO syndrome patients who experienced symptom improvement after treatment with JAKi, specifically tofacitinib, baricitinib, and upadacitinib. However, more research is needed to validate the efficacy of JAKi in treating SAPHO syndrome, including studies on tapering or discontinuation of JAKi and potential relapses or treatment failures. [Extracted from the article]

The commonly used criteria for SAPHO syndrome were proposed by Kahn in 1997 and revised in 2003:[1] (1) bone-joint involvement associated with PPP and psoriasis vulgaris; (2) bone-joint involvement associated with SA; (3) isolated sterile hyperostosis/osteitis; and (4) chronic recurrent multifocal osteomyelitis (children). Upadacitinib effectively relieved bone pain and skin damage in patients, and no significant adverse effects were found; thus, it may be a potential treatment option for SAPHO syndrome. Keywords: autoinflammatory disease; SAPHO syndrome; treatment option; upadacitinib EN autoinflammatory disease SAPHO syndrome treatment option upadacitinib 2335 2337 3 11/03/23 20231101 NES 231101 SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis) is a rare autoinflammatory disease which may manifest clinically as aseptic osteomyelitis and aseptic joint inflammation, with or without cutaneous manifestations.[1] Osteoarticular symptoms occur mainly in the anterior chest wall (ACW) and may also involve the spine and peripheral joints. [Extracted from the article]

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a chronic inflammatory disease characterized by osteoarticular and cutaneous involvement as its main manifestations.[1] Inflammatory bowel disease (IBD) is a chronic inflammatory disease that mainly includes Crohn disease (CD) and ulcerative colitis (UC). Additionally, when patients develop SAPHO syndrome coexisting with IBD, we need to differentiate IBD-related arthritis and SAPHO syndrome. [Extracted from the article]

Background: Synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome is a rare autoinflammatory disease; its primary manifestation includes osteoarthropathy with skin involvement. Janus kinase (JAK) inhibitors, such as tofacitinib, were used for rheumatoid arthritis; however, due to its downregulation of immune cytokines including interleukin (IL)‐6 and IL‐8, it might be effective for SAPHO patients. Case summary: We report the 1st case of mandibular‐related SAPHO syndrome treated with tofacitinib. The patient underwent mandibular resection surgery twice and postoperative pathology showed "osteomyelitis". The patient developed sclerosing osteomyelitis in the left wrist 9 months after surgery and SAPHO syndrome was diagnosed. The patient was administered nonsteroidal anti‐inflammatory drugs and corticosteroids therapy without much remission. A 3‐month tofacitinib therapy provided remission from both systemic inflammation status and peripheral osteoarticular symptoms and no significant recurrence was observed during follow‐up in this case. Conclusion: Mandibular involvement in SAPHO syndrome is easily misdiagnosed due to its rarity. Mandibular resection surgery should be applied carefully; after systemic treatment with tofacitinib, the patient had remission. We provide a successful experience for the treatment of mandibular‐related SAPHO syndrome. [ABSTRACT FROM AUTHOR]