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  • Title: Efficacy of the anti-TNF-alpha antibody infliximab against refractory systemic vasculitides: an open pilot study on 10 patients.
    Author: Bartolucci P, Ramanoelina J, Cohen P, Mahr A, Godmer P, Le Hello C, Guillevin L.
    Journal: Rheumatology (Oxford); 2002 Oct; 41(10):1126-32. PubMed ID: 12364631.
    Abstract:
    OBJECTIVE: Evidence indicates that tumour necrosis factor (TNF) is a major agent in the pathogenesis of vasculitis. We studied the short-term effect of anti-TNF-alpha antibody in systemic vasculitis patients refractory to steroids and immunosuppressive agents. METHODS: Ten patients refractory to corticosteroids and at least one immunosuppressant and who had persistently active disease or a new flare were included. Seven had Wegener's granulomatosis, two had rheumatoid arthritis-associated vasculitis and one had cryoglobulinaemia with mean duration of 9.1, 21.5 and 17 yr. They received infliximab (5 mg/kg) on days 1, 14, 42 and then every 8 weeks. Immunosuppressants were stopped between days 0 and 42 for eight patients, while the steroid dose was maintained or lowered. The treatment response was evaluated clinically with the Birmingham Vasculitis Activity Score 2000 (BVAS). RESULTS: Complete or partial remission was observed in all patients. The mean BVAS at entry was 9.1 (range 4-15) and had declined to 1.9 (range 0-4) by day 42 and 1.3 (range 0-4) at 6 months; BVAS of 0 was recorded for four patients on day 42 and for five at 6 months. The only adverse effect was cutaneous eruption in two patients. CONCLUSION: Anti-TNF-alpha successfully induced prompt symptomatic responses in patients with systemic vasculitis not responding to conventional treatment. Infliximab was well tolerated during the short-term follow-up.
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