Effectiveness of infliximab in treating selected patients with sarcoidosis

SummaryObjectiveTo assess the effectiveness of infliximab (Remicade) in the treatment of patients with sarcoidosis who either do not respond to corticosteroids and other conventional drugs or develop unacceptable side effects to these drugs.DesignA clinical, non-randomized, off-label study.SettingSarcoidosis clinic at a university teaching hospital.PatientsTwelve biopsy-proven sarcoidosis patients, nine women and three men ranging from 45 to 70 years of age with chronic multisystem sarcoidosis refractory to corticosteroids or alternative treatment.InterventionInfliximab was infused at a dedicated ambulatory infusion center. The initial dose was 3 mg/kg body weight and subsequent doses were given at weeks 2, 4, 6, 10, and 14. All patients received at least six infusions.ResultsAll 12 patients improved significantly. One patient had a mild allergic drug reaction that responded to antihistamine. One patient, after 3 months of stopping infliximab treatment, died of a ruptured blood vessel in the abdomen. At autopsy a plasma cell dyscrasia was found.ConclusionInfliximab is safe and effective in treating those patients with multisystem sarcoidosis who are either refractory or develop side effects to a standard regimen of corticosteroids and immunosuppressive agents.