Clinical outcomes in sarcoidosis after cessation of infliximab treatment
Identifieur interne : 001888 ( Main/Exploration ); précédent : 001887; suivant : 001889Clinical outcomes in sarcoidosis after cessation of infliximab treatment
Auteurs : Efstratios Panselinas [Grèce] ; J. Keith Rodgers [États-Unis] ; Marc A. JudsonSource :
- Respirology [ 1323-7799 ] ; 2009-05.
English descriptors
- Teeft :
- Arthritis rheum, Asian society, Authors journal compilation, Cardiac sarcoidosis, Case control etiologic study, Chart review, Clin, Clinical course, Clinical deterioration, Clinical examination, Clinical outcomes, Clinical relapse, Clinical response, Corticosteroid, Corticosteroid dose, Daily dose, Deterioration, Diabetes insipidus, Discontinuation, Disease severity, Drug toxicity, Extrapulmonary sarcoidosis, Gadolinium enhancement, Index organ, Lesion, Lupus pernio, Medical university, Medication, Mental status, Methotrexate, Methotrexate hydroxychloroquine, Natural course, Necrosis therapy, None prednisone, Optic neuritis, Organ involvement, Other organ involvement, Peripheral lymph nodes, Prednisone, Previous case series, Pulmonary hypertension, Pulmonary involvement, Pulmonary medicine, Pulmonary sarcoidosis, Rash, Recalcitrant forms, Recalcitrant sarcoidosis, Refractory sarcoidosis, Respirology, Retrospective study, Sarcoidosis, Sarcoidosis patients, Sismanoglion hospital, Skin lesions, Stable rash, Surt, Total dose, Visual defects.
Abstract
Background and objective: Infliximab appears to be efficacious for the treatment of recalcitrant forms of sarcoidosis. However, there are minimal data concerning the course of sarcoidosis once infliximab is discontinued. Methods: Clinical outcomes in patients who had received infliximab and had discontinued it for at least 2 months were analysed retrospectively. The severity of involvement of the index organ from the time of discontinuation of infliximab was compared with that at the end of the follow‐up period. Results: Fourteen patients with sarcoidosis who had been treated with infliximab and had discontinued this therapy were identified. Before discontinuation of infliximab, 9 of the 14 patients (64%) responded to infliximab treatment and only one (7%) deteriorated. Patients who discontinued infliximab were followed for a mean of 12 months. At the end of the follow‐up period, 12 of the 14 patients (86%) had deteriorated as compared with their status at the time of discontinuation of infliximab and two (14%) had remained stable. Kaplan–Meier analysis of time to clinical deterioration showed that half the patients deteriorated within 3 months of discontinuing infliximab. Patients who had discontinued infliximab appeared to be more likely to have their dose of prednisone increased. Conclusion: Patients with recalcitrant sarcoidosis who receive infliximab appear likely to deteriorate after discontinuation of this medication.
Url:
DOI: 10.1111/j.1440-1843.2009.01518.x
Affiliations:
- Grèce, États-Unis
- Attique (région), Caroline du Sud
- Athènes, Columbia (Caroline du Sud)
- Université de Caroline du Sud
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Judson</name><affiliation><wicri:noCountry code="no comma">Division of Pulmonary and Critical Care Medicine and</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Respirology</title><title level="j" type="alt">RESPIROLOGY</title><idno type="ISSN">1323-7799</idno><idno type="eISSN">1440-1843</idno><imprint><biblScope unit="vol">14</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="522">522</biblScope><biblScope unit="page" to="528">528</biblScope><biblScope unit="page-count">7</biblScope><publisher>Blackwell Publishing Asia</publisher><pubPlace>Melbourne, Australia</pubPlace><date type="published" when="2009-05">2009-05</date></imprint><idno type="ISSN">1323-7799</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1323-7799</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Arthritis rheum</term><term>Asian society</term><term>Authors journal compilation</term><term>Cardiac sarcoidosis</term><term>Case control etiologic study</term><term>Chart review</term><term>Clin</term><term>Clinical course</term><term>Clinical deterioration</term><term>Clinical examination</term><term>Clinical outcomes</term><term>Clinical relapse</term><term>Clinical response</term><term>Corticosteroid</term><term>Corticosteroid dose</term><term>Daily dose</term><term>Deterioration</term><term>Diabetes insipidus</term><term>Discontinuation</term><term>Disease severity</term><term>Drug toxicity</term><term>Extrapulmonary sarcoidosis</term><term>Gadolinium enhancement</term><term>Index organ</term><term>Lesion</term><term>Lupus pernio</term><term>Medical university</term><term>Medication</term><term>Mental status</term><term>Methotrexate</term><term>Methotrexate hydroxychloroquine</term><term>Natural course</term><term>Necrosis therapy</term><term>None prednisone</term><term>Optic neuritis</term><term>Organ involvement</term><term>Other organ involvement</term><term>Peripheral lymph nodes</term><term>Prednisone</term><term>Previous case series</term><term>Pulmonary hypertension</term><term>Pulmonary involvement</term><term>Pulmonary medicine</term><term>Pulmonary sarcoidosis</term><term>Rash</term><term>Recalcitrant forms</term><term>Recalcitrant sarcoidosis</term><term>Refractory sarcoidosis</term><term>Respirology</term><term>Retrospective study</term><term>Sarcoidosis</term><term>Sarcoidosis patients</term><term>Sismanoglion hospital</term><term>Skin lesions</term><term>Stable rash</term><term>Surt</term><term>Total dose</term><term>Visual defects</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background and objective: Infliximab appears to be efficacious for the treatment of recalcitrant forms of sarcoidosis. However, there are minimal data concerning the course of sarcoidosis once infliximab is discontinued. Methods: Clinical outcomes in patients who had received infliximab and had discontinued it for at least 2 months were analysed retrospectively. The severity of involvement of the index organ from the time of discontinuation of infliximab was compared with that at the end of the follow‐up period. Results: Fourteen patients with sarcoidosis who had been treated with infliximab and had discontinued this therapy were identified. Before discontinuation of infliximab, 9 of the 14 patients (64%) responded to infliximab treatment and only one (7%) deteriorated. Patients who discontinued infliximab were followed for a mean of 12 months. At the end of the follow‐up period, 12 of the 14 patients (86%) had deteriorated as compared with their status at the time of discontinuation of infliximab and two (14%) had remained stable. Kaplan–Meier analysis of time to clinical deterioration showed that half the patients deteriorated within 3 months of discontinuing infliximab. Patients who had discontinued infliximab appeared to be more likely to have their dose of prednisone increased. Conclusion: Patients with recalcitrant sarcoidosis who receive infliximab appear likely to deteriorate after discontinuation of this medication.</div></front></TEI><affiliations><list><country><li>Grèce</li><li>États-Unis</li></country><region><li>Attique (région)</li><li>Caroline du Sud</li></region><settlement><li>Athènes</li><li>Columbia (Caroline du Sud)</li></settlement><orgName><li>Université de Caroline du Sud</li></orgName></list><tree><noCountry><name sortKey="Judson, Marc A" sort="Judson, Marc A" uniqKey="Judson M" first="Marc A." last="Judson">Marc A. 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