R P Baughman1, E E Lower. 1. Department of Internal Medicine, University of Cincinnati Medical Center, OH, USA. bob.baughman@uc.edu
Abstract
BACKGROUND AND AIM OF WORK: Tumor necrosis factor-alpha (TNF-alpha) appears to be an important cytokine in the inflammation of sarcoidosis. Infliximab is a chimeric monoclonal antibody which specifically inhibits TNF-alpha. We investigated the efficacy of infliximab for the therapy of chronic, resistant sarcoidosis. METHODS: Patients with persistent symptomatic sarcoidosis despite corticosteroids and immunosuppressive agents were selected for treatment with infliximab. Patients were treated initially and at 2, 4, and 12 weeks with 5 mg/kg of infliximab at each treatment. Index lesions, which had progressed despite corticosteroid therapy, were reevaluated at 16 weeks. RESULTS: Three patients were treated. In two patients, the index lesion was lupus pernio, which significantly improved with infliximab. The third patient had restrictive lung disease. At week 16, there was a 26% improvement in the vital capacity from pretreatment values. All patients tolerated the treatments well. CONCLUSIONS: Infliximab was associated with significant improvement in chronic sarcoidosis.
BACKGROUND AND AIM OF WORK: Tumor necrosis factor-alpha (TNF-alpha) appears to be an important cytokine in the inflammation of sarcoidosis. Infliximab is a chimeric monoclonal antibody which specifically inhibits TNF-alpha. We investigated the efficacy of infliximab for the therapy of chronic, resistant sarcoidosis. METHODS:Patients with persistent symptomatic sarcoidosis despite corticosteroids and immunosuppressive agents were selected for treatment with infliximab. Patients were treated initially and at 2, 4, and 12 weeks with 5 mg/kg of infliximab at each treatment. Index lesions, which had progressed despite corticosteroid therapy, were reevaluated at 16 weeks. RESULTS: Three patients were treated. In two patients, the index lesion was lupus pernio, which significantly improved with infliximab. The third patient had restrictive lung disease. At week 16, there was a 26% improvement in the vital capacity from pretreatment values. All patients tolerated the treatments well. CONCLUSIONS:Infliximab was associated with significant improvement in chronic sarcoidosis.
Authors: Adam P Croft; Deva Situnayake; Omer Khair; Gavin Giovanni; David Carruthers; Arul Sivaguru; Caroline Gordon Journal: Clin Rheumatol Date: 2012-01-17 Impact factor: 2.980