Refractory multisystem sarcoidosis responding to infliximab therapy
Identifieur interne : 001353 ( Main/Exploration ); précédent : 001352; suivant : 001354Refractory multisystem sarcoidosis responding to infliximab therapy
Auteurs : Adam P. Croft [Royaume-Uni] ; Deva Situnayake [Royaume-Uni] ; Omer Khair [Royaume-Uni] ; Gavin Giovanni [Royaume-Uni] ; David Carruthers [Royaume-Uni] ; Arul Sivaguru [Royaume-Uni] ; Caroline Gordon [Royaume-Uni]Source :
- Clinical Rheumatology [ 0770-3198 ] ; 2012-06-01.
English descriptors
- KwdEn :
Abstract
Abstract: Chronic progressive multisystem granulomatous disease is seen in 10–30% of patients with sarcoidosis and can result in end organ damage. Corticosteroids are the mainstay of treatment with the addition of cytotoxic agents in severe cases. Some patients are refractory to such treatment and, therefore, management is a challenge. There is currently limited evidence for biological agents such as infliximab, a monoclonal anti-tumor necrosis factor-α antibody in the treatment of multisystem sarcoidosis. We report outcomes of three patients with extensive multisystem sarcoidosis refractory to conventional treatment and treated at our center. Clinical assessment and radiographic imaging were used to assess the response to infliximab treatment. Infliximab therapy induced clinical remission in all three patients, and this clinical response correlated with radiographic evidence of the resolution of granulomatous disease. Serum ACE level was reduced in all cases, and daily steroid dosage was reduced. We propose that infliximab can be an effective treatment in patients with multisystem complex sarcoidosis refractory to conventional drug therapy and can result in sustained clinical remission. Our experience supports the urgent need for randomized controlled clinical trials of anti-TNF therapy in refractory systemic sarcoidosis.
Url:
DOI: 10.1007/s10067-011-1933-9
Affiliations:
- Royaume-Uni
- Angleterre, Grand Londres, Midlands de l'Ouest
- Birmingham, Londres
- Université de Birmingham, Université de Londres
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Rheumatology</title><title level="j" type="abbrev">Clin Rheumatol</title><idno type="ISSN">0770-3198</idno><idno type="eISSN">1434-9949</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>London</pubPlace><date type="published" when="2012-06-01">2012-06-01</date><biblScope unit="volume">31</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1013">1013</biblScope><biblScope unit="page" to="1018">1018</biblScope></imprint><idno type="ISSN">0770-3198</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0770-3198</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anti-TNF</term><term>Infliximab</term><term>Neurosarcoidosis</term><term>Refractory</term><term>Sarcoidosis</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Chronic progressive multisystem granulomatous disease is seen in 10–30% of patients with sarcoidosis and can result in end organ damage. Corticosteroids are the mainstay of treatment with the addition of cytotoxic agents in severe cases. Some patients are refractory to such treatment and, therefore, management is a challenge. There is currently limited evidence for biological agents such as infliximab, a monoclonal anti-tumor necrosis factor-α antibody in the treatment of multisystem sarcoidosis. We report outcomes of three patients with extensive multisystem sarcoidosis refractory to conventional treatment and treated at our center. Clinical assessment and radiographic imaging were used to assess the response to infliximab treatment. Infliximab therapy induced clinical remission in all three patients, and this clinical response correlated with radiographic evidence of the resolution of granulomatous disease. Serum ACE level was reduced in all cases, and daily steroid dosage was reduced. We propose that infliximab can be an effective treatment in patients with multisystem complex sarcoidosis refractory to conventional drug therapy and can result in sustained clinical remission. Our experience supports the urgent need for randomized controlled clinical trials of anti-TNF therapy in refractory systemic sarcoidosis.</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Midlands de l'Ouest</li></region><settlement><li>Birmingham</li><li>Londres</li></settlement><orgName><li>Université de Birmingham</li><li>Université de Londres</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Croft, Adam P" sort="Croft, Adam P" uniqKey="Croft A" first="Adam P." last="Croft">Adam P. Croft</name></region><name sortKey="Carruthers, David" sort="Carruthers, David" uniqKey="Carruthers D" first="David" last="Carruthers">David Carruthers</name><name sortKey="Croft, Adam P" sort="Croft, Adam P" uniqKey="Croft A" first="Adam P." last="Croft">Adam P. Croft</name><name sortKey="Giovanni, Gavin" sort="Giovanni, Gavin" uniqKey="Giovanni G" first="Gavin" last="Giovanni">Gavin Giovanni</name><name sortKey="Gordon, Caroline" sort="Gordon, Caroline" uniqKey="Gordon C" first="Caroline" last="Gordon">Caroline Gordon</name><name sortKey="Gordon, Caroline" sort="Gordon, Caroline" uniqKey="Gordon C" first="Caroline" last="Gordon">Caroline Gordon</name><name sortKey="Gordon, Caroline" sort="Gordon, Caroline" uniqKey="Gordon C" first="Caroline" last="Gordon">Caroline Gordon</name><name sortKey="Khair, Omer" sort="Khair, Omer" uniqKey="Khair O" first="Omer" last="Khair">Omer Khair</name><name sortKey="Situnayake, Deva" sort="Situnayake, Deva" uniqKey="Situnayake D" first="Deva" last="Situnayake">Deva Situnayake</name><name sortKey="Sivaguru, Arul" sort="Sivaguru, Arul" uniqKey="Sivaguru A" first="Arul" last="Sivaguru">Arul Sivaguru</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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