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.
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Authors | Maria Grazia Catanoso, Lucia Spaggiari, Luca Magnani, Nicolò Pipitone, Annibale Versari, Luigi Boiardi, Giulia Pazzola, Pierpaolo Pattacini, Carlo Salvarani |
Journal | Clinical and experimental rheumatology
(Clin Exp Rheumatol)
2012 Sep-Oct
Vol. 30
Issue 5
Pg. 776-8
ISSN: 0392-856X [Print] Italy |
PMID | 23021007
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Antibodies, Monoclonal
- Glucocorticoids
- Immunosuppressive Agents
- Radiopharmaceuticals
- Fluorodeoxyglucose F18
- Infliximab
- Methotrexate
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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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