Successful treatment of infliximab in a patient with scleroderma

Abstract

Rationale:Systemic Scleroderma (SSc) is a rare connective tissue disease clinically characterized by cutaneous sclerosis and variable systemic involvement. No drug is currently available to effectively reverse the fibrotic process in SSc. Previous reports have suggested that the tumor necrosis factor (TNF) antagonists could be useful for the treatment of fibrotic disorders. However, TNFα has long been considered as an antifibrotic cytokine. Whether TNF antagonist is effective for SSc patients needs to be tested.Patient concerns-Diagnosis:Here we report a case with a 2-year history of SSc who was effectively treated with infliximab in our clinic.Interventions:The patient manifested skin thickening, chest tightness and arthralgia. Before admitted to our clinic, he was treated with methylprednisolone, prostacyclin, D-penicillamine and calcium antagonists but without significant improvement of his signs and symptoms. In our clinic, the patient was treated with infliximab.Outcomes:His signs and symptoms were continued improving during the course of treatment. His skin biopsy showed significant reduction in fibroplasia finally.Lessons:TNF antagonist is an effective treatment for SSc.

Inflammatory arthritis in systemic sclerosis: What to do?

“…Some case reports of SSc patients describe improved joint symptoms and overall clinical stability when treated with infliximab. 72,73 Bosello et al 74 described TNF-alpha inhibition with infliximab followed by etanercept that led to a decrease in joint swelling and tenderness in a case series of four patients with SSc and erosive polyarthritis. A retrospective chart review described that 83% of patients who were treated with etanercept for active joint disease (edema, erythema, warmth, pain, and synovitis) had a positive response including decreased signs of inflammation or synovitis and/or complete resolution of joint symptoms.…”