Treatment of Refractory Churg-Strauss-Syndrome (CSS) by TNF- Blockade

Arbach, Olga; Gross, Wolfgang L.; Gause, A

doi:10.1078/0171-2985-00197

Cited by 81 publications

(28 citation statements)

References 12 publications

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“…Shortly after the introduction of anti-TNF-a agents to the market, several reports appeared about the use of these agents in a variety of vasculitic conditions, such as Wegener granulomatosis, Takayasu arteritis, and ChurgStrauss syndrome [21][22][23]. Therefore, we postulated that infliximab could be efficacious also in treating refractory entero-BD.…”

Section: Discussionmentioning

confidence: 95%

Efficacy of combination therapy of anti-TNF-α antibody infliximab and methotrexate in refractory entero-Behçet’s disease

et al. 2010

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It is often difficult to manage refractory gastrointestinal tract complications of Behçet's disease (entero-BD) by conventional therapy. In this study, we assessed the short- and long-term efficacy and safety of the combination therapy of infliximab, an anti-tumor-necrosis-factor (TNF)-α antibody, and methotrexate in ten patients with refractory entero-BD refractory to conventional therapies. The short- (weeks) and long-term (by 2 years) effects of infliximab at 3-5 mg/kg body weight every 8 weeks on the clinical course and intestinal manifestations were assessed by abdominal computed tomography (CT) and colonoscopy. The primary endpoint was the rate of disappearance of ileocecal ulceration at 12 months of therapy. All patients showed improvement of gastrointestinal symptoms and disease-associated complications within 4 weeks. Furthermore, the rate of disappearance of ileocecal ulcerations was 50% (5/10 patients) at 6 months and 90% (9/10 patients) at 12 months, and, therefore 90% of patients were satisfied with the primary endpoint. Furthermore, corticosteroid dose was significantly reduced from 22.0 to 1.8 mg/day at 24 months. No severe adverse effects were observed during the 24 months of follow-up. We provide evidence for the rapid and excellent efficacy of infliximab in patients with refractory entero-BD and that the combination of infliximab and methotrexate brings about long-term alleviation of entero-BD and excellent tolerability.

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Section: Discussionmentioning

confidence: 95%

Efficacy of combination therapy of anti-TNF-α antibody infliximab and methotrexate in refractory entero-Behçet’s disease

et al. 2010

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“…Clinical Efficacy Infliximab is a chimeric murine/human IgG1 monoclonal antibody that binds specifically to human TNFα [68]. Effects of infliximab in ANCA-associated vasculitis were published in small case reports or series [69][70][71][72] that were followed by larger studies. In an openlabel, multi-center, prospective clinical trial of ANCAassociated systemic vasculitis, infliximab induced remission in 88% of patients [73].…”

Section: Anti-cytokine Therapymentioning

confidence: 99%

Targeted Biologic Approaches to the Treatment of Systemic Vasculitis

Coca

Anolik

2008

Clinic Rev Allerg Immunol

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The introduction of biological agents in the treatment of systemic vasculitis offers the promise of targeted therapy with greater efficacy and fewer side effects than conventional treatments. In this paper, we review the rationale for biological strategies in vasculitis and discuss the results of clinical studies to date. The biotherapies discussed include immune-cell-depleting agents, both B- and T-cell targeted; costimulatory blockade; and cytokine blockade. Although most of these agents remain unproven until ongoing randomized clinical trials are complete, their introduction heralds a new era of vasculitis treatment and has provided novel insights into disease pathogenesis.

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“…Bei lebensbedrohlichen Manifestationen kann neben einer Reintroduktion von Cyclophosphamid eine Gabe von 7 Interferon-α oder intravenösen Immunglobulinen erfolgen. Bei primär therapierefraktären Verläufen sind positive Effekte von TNF-α-Inhibitoren, Rituximab, Interferon-α und intravenösen Immunglobulinen (IVIGs) beschrieben [18,19,20,21]. Die Prognose ist abhängig von der Anzahl der Risikofaktoren.…”

Section: Therapie Und Prognoseunclassified

Das Churg-Strauss-Syndrom

Zwerina¹

2008

Z. Rheumatol.

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Churg-Strauss syndrome is a systemic ANCA-associated vasculitis arising almost exclusively in patients with a pre-existent asthma. Common clinical manifestations are marked blood eosinophilia, asthma, chronic sinusitis, cardiomyopathy, pulmonary infiltrates, gastrointestinal complaints and a multiplex neuropathy. The morphological substrate is an eosinophilic necrotizing vasculitis. Other eosinophilic disorders such as parasitic diseases, allergies and idiopathic hyper-eosinophilic syndrome have to be excluded. The mainstay of therapy is high-dose corticosteroids with the addition of cytotoxic drugs in patients with poor prognosis.

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Treatment of Refractory Churg-Strauss-Syndrome (CSS) by TNF- Blockade

Cited by 81 publications

References 12 publications

Efficacy of combination therapy of anti-TNF-α antibody infliximab and methotrexate in refractory entero-Behçet’s disease

Efficacy of combination therapy of anti-TNF-α antibody infliximab and methotrexate in refractory entero-Behçet’s disease

Targeted Biologic Approaches to the Treatment of Systemic Vasculitis

Das Churg-Strauss-Syndrom

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