Efficacy of infliximab in extrapulmonary sarcoidosis

Researchers from the Medical University of South Carolina investigated the efficacy of infliximab for the treatment of extrapulmonary sarcoidosis.

A prospective, randomized, double-blind, placebo-controlled trial compared a placebo with infliximab 3 mg.kg(-1) and infliximab 5 mg.kg(-1) given over 24 weeks.

Extrapulmonary organ severity was determined by a novel severity tool (extrapulmonary Physician Organ Severity Tool, or ePOST) with an adjustment for the number of organs involved (ePOSTadj). 138 enrolled in a prospective randomized trial of infliximab versus placebo for the treatment of chronic corticosteroid-dependent pulmonary sarcoidosis.

Baseline severity of extrapulmonary organ involvement as measured by ePOST was similar across treatment groups. After 24 weeks of study drug therapy, the change from baseline to week 24 in ePOST for the combined infliximab group compared with the placebo group was greater (p<0.01). After adjustment for the number of extrapulmonary organs involved, the improvement in ePOSTadj observed in the combined infliximab group was also greater to that observed in placebo-treated patients after 24 weeks of therapy (p<0.05). The improvements in ePOST and ePOSTadj were not maintained during a subsequent 24-week washout period.

The resaearchers concluded that infliximab may be beneficial compared with placebo in the treatment of extrapulmonary sarcoidosis in patients already receiving corticosteroids as assessed by this severity tool.

(Source: Judson MA, Baughman RP, Costabel U, Flavin S, Lo KH, Kavuru MS, et al. Efficacy of infliximab in extrapulmonary sarcoidosis: Results from a randomized trial. Eur Respir J. 2008 Feb 6 [Epub ahead of print]: PubMed: March 2008)