Safety and efficacy of infliximab in a patient with active WHO class IV lupus nephritis.

Because disease activity in systemic lupus erythematosus correlates well with increased serum levels and activity of the cytokine tumor necrosis factor alpha (TNF-alpha), we report on the safety and efficacy of infliximab, a chimeric monoclonal antibody directed against TNF-alpha, given to a patient with active lupus with diffuse proliferative nephritis (WHO Class IV). This patient who failed to remit with a combination of full-dose steroids, mycophenolate mofetil, and cyclosporine, went into sustained remission with the addition of infliximab infusions.