Background and Aim of Work: 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. W
e investigated the efficacy of infliximab for the therapy of chronic, resis
tant sarcoidosis. Methods: Patients with persistent symptomatic sarcoidosis
despite corticosteroids and immunosuppressive agents were selected for tre
atment 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 h
ad progressed despite corticosteroid therapy, were reevaluated at 16 weeks.
Results: Three patients were treated. In two patients, the index lesion wa
s lupus pernio, which significantly improved with infliximab. The third pat
ient 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 im
provement in chronic sarcoidosis.