Long term follow-up of infliximab efficacy in pulmonary and extra-pulmonary sarcoidosis refractory to conventional therapy

Russell, Eric J.; Luk, Francis Cheuk Yin; Manocha, Sonia; Ho, Tung Manh; O’Connor, Carolyn R.; Hussain, Humaira

doi:10.1016/j.semarthrit.2012.10.008

Cited by 48 publications

(30 citation statements)

References 29 publications

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“…Inhibition of TNFα using infliximab or adalimumab significantly improved symptoms in patients with chronic sarcoidosis (Baughman et al, 2006; Callejas-Rubio et al, 2008; Chebib et al, 2014; Crommelin et al, 2014; Rossman et al, 2006; Russell et al, 2013; Sweiss et al, 2005); specifically, infliximab improved forced vital capacity (FVC) after 24 weeks of therapy (Baughman et al, 2006). Results with humanized anti-TNF antibody in sarcoidosis have been mixed.…”

Section: Role Of Tnfα In Pulmonary Diseasesmentioning

confidence: 99%

Anti-TNFα therapy in inflammatory lung diseases

Malaviya

Laskin

2017

Pharmacology & Therapeutics

186

137

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Increased levels of tumor necrosis factor (TNF) α have been linked to a number of pulmonary inflammatory diseases including asthma, chronic obstructive pulmonary disease (COPD), acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), sarcoidosis, and interstitial pulmonary fibrosis (IPF). TNFα plays multiple roles in disease pathology by inducing an accumulation of inflammatory cells, stimulating the generation of inflammatory mediators, and causing oxidative and nitrosative stress, airway hyperresponsiveness and tissue remodeling. TNF-targeting biologics, therefore, present a potentially highly efficacious treatment option. This review summarizes current knowledge on the role of TNFα in pulmonary disease pathologies, with a focus on the therapeutic potential of TNFα-targeting agents in treating inflammatory lung diseases.

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Section: Role Of Tnfα In Pulmonary Diseasesmentioning

confidence: 99%

Anti-TNFα therapy in inflammatory lung diseases

Malaviya

Laskin

2017

Pharmacology & Therapeutics

186

137

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“…In case of intolerable side-effects or steroid resistance, second-line treatment options should be considered, such as methotrexate (MTX), azathioprine or leflunomide, but these therapies may also be subject to failure or intolerance [8][9][10]. Another option to consider is TNF inhibitors, which inhibit the potent pro-inflammatory TNF-a, often a predominant problem in patients with refractory sarcoidosis, and these have shown promising results [11][12][13][14]. However, a drawback of TNF inhibitors is considerable treatment costs [15].…”

Section: Introductionmentioning

confidence: 99%

Association of the TNF- G-308A polymorphism with TNF-inhibitor response in sarcoidosis

Wijnen

Cremers

Nelemans

et al. 2014

European Respiratory Journal

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Responsiveness to tumour necrosis factor (TNF) inhibitors has been associated with the TNF-a G-308A polymorphism in rheumatoid arthritis. The aim of this study was to examine the association between the presence of this polymorphism and the response to TNF inhibitors in patients with refractory sarcoidosis.Patients (n5111) who started TNF-inhibitor treatment (76 infliximab, 35 adalimumab) were followed for at least 1 year. The main symptoms in these patients were fatigue (n5100, 90.1%), small fibre neuropathy (n591, 82.0%), pulmonary involvement (n569, 62.2%), and/or uveitis (n531, 27.9%). Patients were additionally genotyped for the presence of the TNF-a G-308A polymorphism. Treatment response was assessed using clinical outcome measures and questionnaires.Three-quarters (n583, 74.8%) of the patients responded well. Of the patients without the variant A-allele 93.6% (73 out of 78, p,0.001) improved, while 30.3% (10 out of 33) of variant A-allele carriers responded favourably to TNF inhibitors. For patients with the GG-genotype, the probability of improving compared with remaining stable or deteriorating was three times higher (risk ratio 3.09, 95% CI 1. 84-5.20).Sarcoidosis patients without the TNF-a -308A variant allele (GG-genotype) had a three-fold higher response to TNF inhibitors (adalimumab or infliximab). Further research is needed to evaluate the value of genotyping for the TNF-a G-308A polymorphism in order to tailor TNF-inhibitor treatment. @ERSpublications TNF-a G-308A polymorphism predicts TNF-inhibitor response in refractory sarcoidosis: a step to personalised medicine?

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“…Infliximab is administered to CD patients who have no reactions to steroids or immunosuppressive drugs. Also, additional evidence exists that infliximab is effective in patients with sarcoidosis who have had no positive reactions to steroids or general treatments [4]. Recently, anti-TNF-α therapy was reported to induce paradoxical inflammations, vasculitis, lupus, and sarcoidosis [56].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Sarcoidosis That Developed During the Treatment of a Patient With Crohn Disease by Using Infliximab

et al. 2017

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For inflammatory bowel disease (IBD), antitumor necrosis factor treatment offers a new direction for both patients and medical doctors. This treatment has dramatically improved the quality of life for patients with ulcerative colitis and Crohn disease (CD). However, with increasing usage and longer follow-up periods, a wider range of possible adverse effects may be encountered. We report an unusual case of pulmonary sarcoidosis developed during the treatment of a patient with CD by using infliximab. A 30-year-old male who had been treated for CD with infliximab for 18 months was admitted due to abnormal opacities on chest radiography. Chest computed tomography displayed clustered small nodules in both lobes and enlarged multiple lymph nodes. The patient was diagnosed with sarcoidosis from the results of a biopsy of the subcarinal lymph node. Lung lesions were improved five months after infliximab was stopped.

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Long term follow-up of infliximab efficacy in pulmonary and extra-pulmonary sarcoidosis refractory to conventional therapy

Cited by 48 publications

References 29 publications

Anti-TNFα therapy in inflammatory lung diseases

Anti-TNFα therapy in inflammatory lung diseases

Association of the TNF- G-308A polymorphism with TNF-inhibitor response in sarcoidosis

Pulmonary Sarcoidosis That Developed During the Treatment of a Patient With Crohn Disease by Using Infliximab

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