Figueiredo, ASOliveira, ALCaetano, AMoraes-Fontes, MF2020-05-222020-05-222020-01Clin Rheumatol . 2020 Jan;39(1):177-187http://hdl.handle.net/10400.17/3467SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome is a heterogeneous condition combining osteoarticular and cutaneous manifestations. Conventional treatments are mostly ineffective. We hereby report two patients, the first with an aggressive form of disease and the second with an incomplete response to two different anti-TNF-α agents. Both were successfully treated with tocilizumab and ustekinumab, respectively, over a long period of time. A narrative review of a biological therapy in SAPHO syndrome yielded very little information on the specific use of these agents. We highlight the advantages of personalising therapy and describe emerging promising treatments for this disease.engAcquired Hyperostosis Syndrome / diagnosis*Acquired Hyperostosis Syndrome / drug therapy*AdultFemaleMaleHCC IMAHCC DAUTOIMHumansAcquired Hyperostosis Syndrome / immunologyAntibodies, Monoclonal, Humanized / therapeutic useBone and Bones / diagnostic imaging*Middle AgedRadionuclide ImagingTreatment OutcomeTumor Necrosis Factor Inhibitors / therapeutic use*Ustekinumab / therapeutic usejournal article10.1007/s10067-019-04675-2