Infliximab therapy in pulmonary fibrosis associated with collagen vascular disease

To study the potential effectiveness of tumor necrosis factor a (TNF-alpha) inhibitor treatment for pulmonary fibrosis associated with a collagen vascular disease, CVD (rheumatoid arthritis, RA and systemic sclerosis, SSc) refractory to conventional treatment. Four patients (three men with RA, one w...

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Bibliographic Details
Published in:Clinical and experimental rheumatology 2007, Vol.25 (1), p.23-28
Main Authors: ANTONIOU, K. M, MAMOULAKI, M, MALAGARI, K, KRITIKOS, H. D, BOUROS, D, SIAFAKAS, N. M, BOUMPAS, D. T
Format: Article
Language:English
Subjects:
Aged
Antibodies, Monoclonal - therapeutic use
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - complications
Biological and medical sciences
Diseases of the osteoarticular system
Female
Humans
Inflammatory joint diseases
Infliximab
Male
Medical sciences
Middle Aged
Pneumology
Pulmonary Fibrosis - diagnostic imaging
Pulmonary Fibrosis - drug therapy
Pulmonary Fibrosis - etiology
Radiography
Respiratory Function Tests
Respiratory system : syndromes and miscellaneous diseases
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Scleroderma, Systemic - complications
Treatment Outcome
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Summary:To study the potential effectiveness of tumor necrosis factor a (TNF-alpha) inhibitor treatment for pulmonary fibrosis associated with a collagen vascular disease, CVD (rheumatoid arthritis, RA and systemic sclerosis, SSc) refractory to conventional treatment. Four patients (three men with RA, one woman with SSc) were treated with infliximab. All patients received 3mg/kgr of infliximab at intervals 0, 2 and 6 weeks, and then maintenance infusions every 8 weeks afterwards for at least a 12-month period. Patients had active disease despite treatment with corticosteroids and other immunomodulatory agents. Treatment was well-tolerated from all patients. Pulmonary fibrosis remained stable during treatment in terms of symptoms, pulmonary function tests (PFTs) and High resolution computed tomography (HRCT) appearance. As expected, a clinical response was observed in joint symptoms in patients with RA as evaluated by the DAS28 (Disease Activity Score, the 28 joint version). This study suggests that inhibition of TNF-alpha with infliximab may stabilize the progression of pulmonary fibrosis associated with CVD. Prospective, controlled trials are necessary to determine the efficacy of infliximab in pulmonary fibrosis associated CVD.
ISSN:0392-856X
1593-098X