BACKGROUND: Limited evidence exists demonstrating an effective treatment for chronic cutaneous sarcoidosis. OBJECTIVE: To determine infliximab's effectiveness in sarcoidosis. METHODS: We conducted a subset analysis from a randomized, double-blind, placebo-controlled trial for chronic pulmonary sarcoidosis to determine infliximab's effectiveness. Patients with chronic cutaneous sarcoidosis received infliximab (3 or 5 mg/kg) or placebo over 24 weeks. Of 138 patients, the subset analysis evaluated 17 patients with chronic facial and another 9 patients with nonfacial skin involvement. The SASI evaluated lesions for degree of erythema, desquamation, induration, and percentage of area involved. Facial and nonfacial lesions were scored in a blinded manner. RESULTS: Among 5 placebo-treated and 12 infliximab-treated patients, an improvement was observed with infliximab versus placebo in change from baseline to weeks 12 and 24 in desquamation (P<0.005) and induration (P<0.01) at week 24. Erythema, percentage of area involved and the evaluation of paired photographs did not reveal significant differences. LIMITATIONS: Sample size; more extensive disease in placebo patients; chronic therapy upon enrollment; lung as primary organ of sarcoidosis involvement; limited investigator experience with SASI. CONCLUSIONS:Infliximab appears to be a beneficial treatment for chronic cutaneous sarcoidosis. The SASI scoring system demonstrated significant improvement versus placebo in lesion desquamation and induration.
RCT Entities:
BACKGROUND: Limited evidence exists demonstrating an effective treatment for chronic cutaneous sarcoidosis. OBJECTIVE: To determine infliximab's effectiveness in sarcoidosis. METHODS: We conducted a subset analysis from a randomized, double-blind, placebo-controlled trial for chronic pulmonary sarcoidosis to determine infliximab's effectiveness. Patients with chronic cutaneous sarcoidosis received infliximab (3 or 5 mg/kg) or placebo over 24 weeks. Of 138 patients, the subset analysis evaluated 17 patients with chronic facial and another 9 patients with nonfacial skin involvement. The SASI evaluated lesions for degree of erythema, desquamation, induration, and percentage of area involved. Facial and nonfacial lesions were scored in a blinded manner. RESULTS: Among 5 placebo-treated and 12 infliximab-treated patients, an improvement was observed with infliximab versus placebo in change from baseline to weeks 12 and 24 in desquamation (P<0.005) and induration (P<0.01) at week 24. Erythema, percentage of area involved and the evaluation of paired photographs did not reveal significant differences. LIMITATIONS: Sample size; more extensive disease in placebo patients; chronic therapy upon enrollment; lung as primary organ of sarcoidosis involvement; limited investigator experience with SASI. CONCLUSIONS:Infliximab appears to be a beneficial treatment for chronic cutaneous sarcoidosis. The SASI scoring system demonstrated significant improvement versus placebo in lesion desquamation and induration.
Authors: C S Monast; K Li; M A Judson; R P Baughman; E Wadman; R Watt; P E Silkoff; E S Barnathan; C Brodmerkel Journal: Clin Exp Immunol Date: 2017-03-27 Impact factor: 4.330
Authors: Khalid Al-Kofahi; Peter Korsten; Christian Ascoli; Shanti Virupannavar; Mehdi Mirsaeidi; Ian Chang; Naim Qaqish; Lesley A Saketkoo; Robert P Baughman; Nadera J Sweiss Journal: Ther Clin Risk Manag Date: 2016-11-07 Impact factor: 2.423