Infliximab for refractory sarcoidosis

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.