Doty John D, Mazur Joseph E, Judson Marc A
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, USA.
Chest. 2005 Mar;127(3):1064-71. doi: 10.1378/chest.127.3.1064.
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.
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.
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.
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.
背景/目的：许多结节病患者因副作用无法耐受皮质类固醇或其他治疗药物，或对这些药物治疗无效。我们报告使用英夫利昔单抗治疗此类患者的经验。
一组因药物治疗失败或出现无法耐受的副作用而导致传统结节病治疗无效的患者，被给予英夫利昔单抗治疗。对他们的病历进行回顾性分析。
对10例接受英夫利昔单抗治疗的患者进行了分析。10例患者中有9例报告治疗后症状改善，所有10例均有客观改善证据。1例患者在治疗数月后出现药物反应，1例患者发生口腔念珠菌病，另1例患者发生血管免疫母细胞性淋巴瘤。在英夫利昔单抗治疗时正在接受皮质类固醇治疗的6例患者中，有5例患者的皮质类固醇剂量减少。
英夫利昔单抗似乎是治疗难治性结节病患者的一种有效、安全的治疗方法，包括冻疮样狼疮、葡萄膜炎、肝结节病和神经结节病等表现。英夫利昔单抗似乎具有减少类固醇使用的作用。接受该药物治疗的患者应筛查潜伏性结核和淋巴增殖性疾病。
