Infliximab for chronic cutaneous sarcoidosis: a subset analysis from a double-blind randomized clinical trial

Main Article Content

Robert P. Baughman
Marc A. Judson
Elyse E. Lower
Marjolein Drent
Ulrich Costabel
Susan Flavin
Kim Hung Lo
Elliot S. Barnathan
on behalf of the Sarcoidosis Investigators

Keywords

infliximab, cutaneous sarcoidosis, pulmonary, sarcoidosis, sarcoidosis activity and severity index, tumor necrosis factor-alpha

Abstract

 

 Background: Limited evidence exists demonstrating an effective treatment for chronic cutaneous sarcoidosis. Objective: To determine infliximab’s effectiveness in sarcoidosis. Methods: We conducted a subset analysis from a randomized, double-blind, placebo-controlled trial for chronic pulmonary sarcoidosis to determine infliximab’s effectiveness. Patients with chronic cutaneous sarcoidosis received infliximab (3 or 5 mg/kg) or placebo over 24 weeks. Of 138 patients, the subset analysis evaluated 17 patients with chronic facial and another 9 patients with nonfacial skin involvement. The SASI evaluated lesions for degree of erythema, desquamation, induration, and percentage of area involved. Facial and nonfacial lesions were scored in a blinded manner. Results: Among 5 placebo-treated and 12 infliximab-treated patients, an improvement was observed with infliximab versus placebo in change from baseline to weeks 12 and 24 in desquamation (P<0.005) and induration (P<0.01) at week 24. Erythema, percentage of area involved and the evaluation of paired photographs did not reveal significant differences. Limitations: Sample size; more extensive disease in placebo patients; chronic therapy upon enrollment; lung as primary organ of sarcoidosis involvement; limited investigator experience with SASI. Conclusions: Infliximab appears to be a beneficial treatment for chronic cutaneous sarcoidosis. The SASI scoring system demonstrated significant improvement versus placebo in lesion desquamation and induration. (Sarcoidosis Vasc Diffuse Lung Dis 2015; 32: 289-295)

 

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