Adverse events and efficacy of TNF-alpha blockade with infliximab in patients with systemic lupus erythematosus : long-term follow-up of 13 patients.

Aringer, Martin;Houssiau, Frédéric;Gordon, Caroline;Graninger, Winfried B;Smolen, Josef S;et.al.
(2009) Rheumatology (Print) — Vol. 48, n° 11, p. 1451-1454 (2009)

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  • Aringer, Martin
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  • Gordon, Caroline
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  • Graninger, Winfried B
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  • Smolen, Josef S
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Abstract
(en) 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
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Aringer, M., Houssiau, F., Gordon, C., Graninger, W. B., Voll, R. E., Rath, E., Steiner, G., & Smolen, J. S. (2009). Adverse events and efficacy of TNF-alpha blockade with infliximab in patients with systemic lupus erythematosus : long-term follow-up of 13 patients. Rheumatology (Print), 48(11), 1451-1454. https://doi.org/10.1093/rheumatology/kep270 (Original work published 2009)