Rheumatology Advance Access originally published online on September 11, 2009
Rheumatology 2009 48(11):1451-1454; doi:10.1093/rheumatology/kep270
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse events and efficacy of TNF-
blockade with infliximab in patients with systemic lupus erythematosus: long-term follow-up of 13 patients
1Department of Medicine III, Division of Rheumatology, University Clinical Center Carl Gustav Carus at the Technical University of Dresden, Dresden, Germany, 2Department of Rheumatology, Internal Medicine III, Medical University of Vienna, Vienna, Austria, 3Department of Rheumatology, Cliniques Universitaires St Luc, Université Catholique de Louvain, Bruxelles, Belgium, 4School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK, 5Department of Medicine, Division of Rheumatology, Medical University of Graz, Graz, Austria and 6Department of Internal Medicine III and Institute of Clinical Immunology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
Correspondence to: Martin Aringer, Department of Medicine III, Division of Rheumatology, University Clinical Center Carl Gustav Carus at the Technical University of Dresden, Fetscherstrasse 74, 01307 Dresden, Germany. E-mail: martin.aringer{at}uniklinikum-dresden.de
 |
Abstract |
|---|
Objective. To follow-up on all available infliximab-treated SLE patients for safety and long-term efficacy in order to extract information that is useful for planning appropriate controlled trials with infliximab in SLE.
Methods. We analysed charts of six patients treated in an open-label safety trial and seven additional patients treated with infliximab on a compassionate care basis for uncontrolled SLE organ inflammation.
Results. Out of nine patients with lupus nephritis, six had a long-term response after four infusions of infliximab in combination with AZA, lasting for up to 5 years. All five patients with lupus arthritis responded, but this response did not last for >2 months after the last infusion. One additional patient had a long-lasting improvement in SLE interstitial lung disease. No symptoms suggestive of infliximab-induced SLE flares occurred in any patients. Short-term treatment appeared relatively safe, but one patient developed deep-vein thrombosis and several infections. Under long-term therapy, two patients had life-threatening or fatal events, namely CNS lymphoma and Legionella pneumonia. Retreatment and treatment without concomitant immunosuppression led to drug reactions.
Conclusions. Short-term therapy with four infusions of infliximab in combination with AZA was relatively safe, and had remarkable long-term efficacy for lupus nephritis and, potentially, also interstitial lung disease. Long-term therapy with infliximab, however, was associated with severe adverse events in two out of three SLE patients, which may have been provoked by infliximab and/or by their long-standing refractory SLE and previous therapies.
KEY WORDS: Systemic lupus erythematosus, Lupus nephritis, Tumor necrosis factor-
, Infliximab, Safety
Submitted 3 March 2009;
revised version accepted 29 July 2009.
CiteULike 
Connotea 
Del.icio.us What's this?