背景:最近,JAKi也已被广泛证明是一种有效的替代治疗滑膜炎痤疮脓疱症-骨增生-骨炎(SAPHO)病例的常规治疗方法,在多种药物(包括上述药物)失败后。但是,当所有这些治疗失败时,该怎么办?我们报告了一例雷公藤hook(TwHF)治疗缓解的病例。
方法:患者接受非甾体抗炎药治疗,口服泼尼松,米诺环素,双膦酸盐注射液,依那西普,还有托法替尼,但症状没有明显变化。用TwHF治疗(1.0mg/kg/天,患者体重60kg)开始24周。
结果:经过50个月不满意的治疗,这个病人最后用草药TwHF治疗,治疗6个月后,患者的磁共振成像和炎症指标明显改善,表明疾病得到了更好的控制。
结论:在这项研究中,TwHF成功治疗难治性SAPHO综合征患者,该患者对多种西药治疗难治性,无明显不良反应或毒性。但需要进一步随访以确定长期疗效.仍需要更多的病例报告以及临床试验来证实TwHF是否能有效治疗难治性SAPHO综合征。
BACKGROUND: Recently, JAKi has also been widely proved to be an effective alternative to conventional treatment for Synovitis acne pustulosis-hyperostosis-osteitis (SAPHO) cases, after failure of multiple drugs including those described above. But what to do when all these treatments fail? We report a case of remission from Tripterygium wilfordii Hook (TwHF) treatment.
METHODS: The patient was treated with nonsteroidal anti-inflammatory drugs, oral prednisone, minocycline, bisphosphonate injection, etanercept, and tofacitinib, but the symptoms did not change significantly. Treatment with TwHF (1.0 mg/kg/day, patient weight 60 kg) was started for 24 weeks.
RESULTS: After 50 months of unsatisfactory treatment, this patient was finally treated with herbal TwHF, and after 6 months of treatment, the patient\'s magnetic resonance imaging and inflammatory indexes were significantly improved, indicating that the disease had been better controlled.
CONCLUSIONS: In this study, TwHF was successful in treating a patient with refractory SAPHO syndrome who was refractory to multiple Western medications without significant adverse effects or toxicities, but further follow-up is needed to determine long-term efficacy. More case reports as well as clinical trials are still needed to confirm whether TwHF can effectively treat refractory SAPHO syndrome.