Treatment of refractory neurosarcoidosis with Infliximab

Background Neurological involvement in sarcoidosis is serious and often aggressive. Many patients respond to steroids but some show a progressive course despite treatment with steroids and even more potent immunosuppressive drugs. Objective The aim of this study was to describe our experience in the treatment of refractory neurosarcoidosis with Infliximabd-its effect on the course of the disease and side effects. Methods A series of four patients are reported with neurosarcoidosis refractory to treatment with steroids combined with various immunosuppressive drugs in whom Infliximab was used. Results A good response, with improvement or stabilisation of the neurological condition, was seen in all cases, without significant side effects. Infliximab is a chimeric monoclonal antibody that neutralises the biological activity of tumour necrosis factor a, a cytokine thought to play an important role in the pathophysiology of sarcoidosis. Conclusion Our experience using Infliximab adds to the growing evidence that it may fulfil a useful role in cases of refractory neurosarcoidosis.