Treatment of refractory neurosarcoidosis with Infliximab

J Neurol Neurosurg Psychiatry. 2010 Mar;81(3):241-6. doi: 10.1136/jnnp.2008.149989. Epub 2008 Oct 31.

Abstract

Background: Neurological involvement in sarcoidosis is serious and often aggressive. Many patients respond to steroids but some show a progressive course despite treatment with steroids and even more potent immunosuppressive drugs.

Objective: The aim of this study was to describe our experience in the treatment of refractory neurosarcoidosis with Infliximab--its effect on the course of the disease and side effects.

Methods: A series of four patients are reported with neurosarcoidosis refractory to treatment with steroids combined with various immunosuppressive drugs in whom Infliximab was used.

Results: A good response, with improvement or stabilisation of the neurological condition, was seen in all cases, without significant side effects. Infliximab is a chimeric monoclonal antibody that neutralises the biological activity of tumour necrosis factor alpha, a cytokine thought to play an important role in the pathophysiology of sarcoidosis.

Conclusion: Our experience using Infliximab adds to the growing evidence that it may fulfil a useful role in cases of refractory neurosarcoidosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Brain / drug effects
  • Brain / pathology
  • Brain Diseases / diagnosis
  • Brain Diseases / drug therapy*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Follow-Up Studies
  • Humans
  • Infliximab
  • Infusions, Intravenous
  • Magnetic Resonance Imaging
  • Male
  • Neurologic Examination / drug effects
  • Sarcoidosis / diagnosis
  • Sarcoidosis / drug therapy*
  • Spinal Cord / drug effects
  • Spinal Cord / pathology
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Tumor Necrosis Factor-alpha
  • Infliximab