C-reactive protein predicts response to infliximab in patients with chronic sarcoidosis.

Abstract

BACKGROUND:

This study assessed the value of C-reactive protein as a predictor of disease severity and response to infliximab therapy in patients with chronic pulmonary sarcoidosis.

DESIGN:

Sera were collected through week 52 from 138 patients with chronic pulmonary sarcoidosis who received placebo or infliximab in a randomized, double-blind, placebo-controlled study. We evaluated the response to therapy by baseline CRP using a dichotomous cutpoint (0.8 mg/dL) for the change from baseline in percent-predicted forced vital capacity (FVC), Saint George's Respiratory Questionnaire (SGRQ), 6-minute walk distance (6MWD), Borg's CR10 dyspnea score, and Physician Organ Assessment (POA).

RESULTS:

CRP was elevated in 36% of patients at baseline, and was significantly reduced by infliximab by week 2. Among patients with elevated baseline CRP, infliximab-treated patients improved significantly compared with placebo-treated patients in percent-predicted FVC (+2.5 versus -2.6%), 6MWD (+8.0 versus -34.1), Borg's CR10 dyspnea score (pre-6MWD -0.8 versus +0.9, post-6MWD -1.1 versus +0.8), and POA (-3.1 versus -0.3). Patients with lower CRP levels at baseline did not show significant differences between the placebo and infliximab groups in most endpoints evaluated.

CONCLUSIONS:

In chronic sarcoidosis patients, elevated CRP appears to identify a subset with more severe disease who may respond better to treatment with infliximab.

• Authors: N J Sweiss, E S Barnathan, K Lo, M A Judson, R Baughman, T48 Investigators
• Journal: Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG (Sarcoidosis Vasc Diffuse Lung Dis) Vol. 27 Issue 1 Pg. 49-56 (Jul 2010) ISSN: 1124-0490 [Print] Italy
• PMID: 21086905 (Publication Type: Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Antibodies, Monoclonal
• Biomarkers
• C-Reactive Protein
• Infliximab

Topics

• Adult
• Anti-Inflammatory Agents (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Biomarkers (blood)
• C-Reactive Protein (metabolism)
• Chronic Disease
• Clinical Trials, Phase II as Topic
• Double-Blind Method
• Dyspnea (drug therapy, immunology)
• Exercise Test
• Exercise Tolerance
• Female
• Humans
• Infliximab
• Male
• Middle Aged
• Multicenter Studies as Topic
• Randomized Controlled Trials as Topic
• Retrospective Studies
• Sarcoidosis, Pulmonary (drug therapy, immunology, physiopathology)
• Severity of Illness Index
• Surveys and Questionnaires
• Time Factors
• Treatment Outcome
• United States
• Vital Capacity
• Walking