Infliximab for Treatment of Neurosarcoidosis

Infliximab, a monoclonal antibody against tumor necrosis factor-α, is approved for use in rheumatoid arthritis and psoriasis; it has also been used off-label in neurosarcoidosis. This case series of 66 patients details the experience at six U.S. academic centers. All cases were biopsy-confirmed. The most common dose was 5 mg/kg, given at 0, 2, and 6 weeks, with maintenance infusions every 4 to 8 weeks.

Isolated CNS sarcoidosis occurred in 20% of patients. Median time from disease onset to infliximab initiation was 2 years, and median time of follow-up was 1.5 years. Steroid-sparing immunosuppressants were started before infliximab in 79% and used concomitantly with infliximab in 76%. Glucocorticoids were weaned in 40%, and 45% were on predni…