Infliximab for refractory sarcoidosis.
OBJECTIVE
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.
Baughman
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Department of Internal Medicine, University of Cincinnati Medical Center, OH, USA. bob.baughman@uc.edu
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D000911:Antibodies, Monoclonal / Q000494:pharmacology*; D002908:Chronic Disease; D004351:Drug Resistance; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012129:Respiratory Function Tests; D012507:Sarcoidosis / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D000069285:Infliximab