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(Chest. 2005;127:1064-1071.)
© 2005 American College of Chest Physicians

Treatment of Sarcoidosis With Infliximab*

John D. Doty, MD; Joseph E. Mazur, PharmD and Marc A. Judson, MD, FCCP

* From the Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology (Drs. Doty and Judson), and Department of Pharmacy Services, College of Pharmacy (Dr. Mazur), Medical University of South Carolina, Charleston, SC.

Correspondence to: Marc A. Judson, MD, FCCP, Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, 96 Jonathan Lucas St, Suite 812-CSB, PO Box 250623, Charleston, SC 29425; e-mail: judsonma{at}musc.edu

Background/objectives: Many patients with sarcoidosis are unable to tolerate corticosteroids or alternative therapeutic agents due to side effects or have disease refractory to these agents. We report our experience using infliximab to treat such patients.

Methods: A group of patients in whom traditional sarcoidosis therapy failed, either due to drug failure or intolerable side effects, were prescribed infliximab. Their charts were retrospectively reviewed.

Results: Ten patients receiving infliximab were reviewed. Nine of the 10 patients reported a symptomatic improvement with therapy, and all 10 demonstrated objective evidence of improvement. A drug reaction developed in one patient after several months of therapy, oral candidiasis developed in one patient, and angioimmunoblastic lymphoma developed in another patient. The corticosteroid dose was reduced in five of the six patients who were receiving corticosteroids at the time of infliximab therapy.

Conclusion: Infliximab appears to be an effective, safe treatment for patients with refractory sarcoidosis, including such manifestations as lupus pernio, uveitis, hepatic sarcoidosis, and neurosarcoidosis. Infliximab appears to be steroid sparing. Patients receiving the drug should be screened for latent tuberculosis and lymphoproliferative disorders.

Key Words: corticosteroids • infliximab • sarcoidosis • therapy




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