Changes in disease activity, lung function and quality of life in patients with refractory sarcoidosis after anti-TNF treatment

Abstract

Objectives: The effect of infliximab therapy in rheumatoid arthritis and Crohn's disease has been well documented. However, literature on infliximab therapy in the rare disease sarcoidosis is scarce. The aim of our study is to evaluate change in disease activity and quality of life upon infliximab treatment in patients with refractory sarcoidosis.

Research design and methods: Retrospective cohort study of 48 patients who received infliximab treatment at a national referral center for sarcoidosis. The clinical effect of infliximab treatment was analyzed in terms of change in disease activity (¹⁸F-FDG PET, serum angiotensin-converting-enzyme [ACE], serum-soluble interleukin-2 receptor [sIL-2R]), lung function (predicted VC, FEV₁ and DLCOc), fatigue severity (CIS) and physical functioning (SF-36). Study parameters were assessed before the first dose (week 0) and after the last dose (week 18).

Results: We found significant decreases in the serum markers ACE and sIL-2R and in SUV_max on ¹⁸F-FDG PET. Furthermore, a significant improvement in fatigue severity and physical functioning scores was observed. In patients with a pulmonary treatment indication, we found significant improvements in percentages of predicted VC (7.6%), FEV₁ (7.9%) and DLCOc (3.5%).

Conclusions: Infliximab improves PET-scan, serum markers, lung function and quality of life in patients with refractory sarcoidosis.

Keywords::

• anti-TNF-α
• disease activity
• lung function
• quality of life
• sarcoidosis

Acknowledgments

The authors thank H van Velzen-Blad for converting the different immunoassays used in the sIL-2R measurements.

Notes