Treatment of refractory neurosarcoidosis with Infliximab.

Abstract

Neurological involvement in sarcoidosis is serious and often aggressive. Many patients respond to steroids but some show a progressive course despite treatment with steroids and even more potent immunosuppressive drugs. The aim of this study was to describe our experience in the treatment of refractory neurosarcoidosis with Infliximab--its effect on the course of the disease and side effects. A series of four patients are reported with neurosarcoidosis refractory to treatment with steroids combined with various immunosuppressive drugs in whom Infliximab was used. A good response, with improvement or stabilisation of the neurological condition, was seen in all cases, without significant side effects. Infliximab is a chimeric monoclonal antibody that neutralises the biological activity of tumour necrosis factor alpha, a cytokine thought to play an important role in the pathophysiology of sarcoidosis. Our experience using Infliximab adds to the growing evidence that it may fulfil a useful role in cases of refractory neurosarcoidosis.