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Efficacy of infliximab in a patient with refractory idiopathic retroperitoneal fibrosis.

Abstract
Glucocorticoids are the mainstay of treatment of idiopathic retroperitoneal fibrosis (IRF). However, relapses are frequent upon tapering of the glucocorticoid dose. A variety of traditional immunosuppressants have been proposed as steroid-sparing agents, but some patients fail to adequately respond to combined glucocorticoid and immunosuppressive therapy. We report a patient with IRF refractory to combined glucocorticoid and methotrexate therapy treated with the anti-TNF-α monoclonal antibody infliximab. Infliximab was administered at 5 mg/kg/bodyweight at week 0, 2, 6 and 8-weekly thereafter for 3 consecutive years. Drug efficacy and safety were assessed clinically and by laboratory tests at treatment onset and subsequently before each infusion. In addition, 18FFluorodeoxyglucose (FDG) positron emission computerised tomography (PET/CT) and abdominal CT scans were used to monitor disease activity and response to treatment. Infliximab therapy resulted in a satisfactory clinical and laboratory response paralleled by an improvement in imaging findings. No serious adverse events were noted. Infliximab may be an effective and safe treatment for refractory IRF. A controlled study is required to confirm our findings.
AuthorsMaria Grazia Catanoso, Lucia Spaggiari, Luca Magnani, Nicolò Pipitone, Annibale Versari, Luigi Boiardi, Giulia Pazzola, Pierpaolo Pattacini, Carlo Salvarani
JournalClinical and experimental rheumatology (Clin Exp Rheumatol) 2012 Sep-Oct Vol. 30 Issue 5 Pg. 776-8 ISSN: 0392-856X [Print] Italy
PMID23021007 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antibodies, Monoclonal
  • Glucocorticoids
  • Immunosuppressive Agents
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Infliximab
  • Methotrexate
Topics
  • Antibodies, Monoclonal (therapeutic use)
  • Drug Resistance
  • Female
  • Fluorodeoxyglucose F18
  • Glucocorticoids (therapeutic use)
  • Humans
  • Immunosuppressive Agents (therapeutic use)
  • Infliximab
  • Methotrexate (therapeutic use)
  • Middle Aged
  • Positron-Emission Tomography
  • Predictive Value of Tests
  • Radiopharmaceuticals
  • Retroperitoneal Fibrosis (diagnostic imaging, drug therapy)
  • Tomography, X-Ray Computed
  • Treatment Outcome

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