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Infliximab in neurosarcoidosis: a systematic review and meta‐analysis

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Title: Infliximab in neurosarcoidosis: a systematic review and meta‐analysis
Authors: Siwakorn Chaiyanarm, Piraya Satiraphan, Natnasak Apiraksattaykul, Jiraporn Jitprapaikulsan, Weerapat Owattanapanich, Tarinee Rungjirajittranon, Witsarut Nanthasi
Source: Annals of Clinical and Translational Neurology, Vol 11, Iss 2, Pp 466-476 (2024)
Publisher Information: Wiley, 2024.
Publication Year: 2024
Collection: LCC:Neurosciences. Biological psychiatry. Neuropsychiatry
LCC:Neurology. Diseases of the nervous system
Subject Terms: Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, RC346-429
More Details: Abstract Objectives To evaluate the clinical outcomes and relapse rates in neurosarcoidosis patients administered infliximab. Methods A systematic review was conducted using the MEDLINE, EMBASE, SCOPUS, and Cochrane Library databases. The search included studies from their inception to March 2023. We included case‐series studies with at least 10 neurosarcoidosis patients undergoing any treatment type. Studies were also required to report at least one of the following outcomes: response rate, overall survival rate, or relapse rate. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. A random‐effects model facilitated the analysis of proportional treatment outcomes. Study quality was evaluated using the modified Newcastle–Ottawa quality assessment scale, while a funnel plot helped detect any publication bias. Results Seven studies comprising 237 patients with neurosarcoidosis were included in the analysis. Of these patients, 184 (77.6%) received treatment with infliximab. The pooled proportion of patients showing clinical improvement after infliximab treatment was 0.74 (95% CI 0.64–0.84, I2 = 49.73%). Relapse rates, derived from four studies, stood at 0.38 (95% CI 0.22–0.55, I2 = 56.92%). Most studies reported successful tapering or cessation of corticosteroid dosage in patients receiving infliximab. Adverse effects were reported in 52 (29.4%) patients, of which 39 out of 54 events (72.2%) were linked to infections. Interpretation Infliximab demonstrated potential improvement in clinical outcomes for patients with refractory neurosarcoidosis and showed potential for reducing the dosage of concurrent corticosteroids. However, a degree of relapse was observed, with infections being the primary concern for adverse events.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2328-9503
Relation: https://doaj.org/toc/2328-9503
DOI: 10.1002/acn3.51968
Access URL: https://doaj.org/article/d6e638a980cc460c80185f7aa1148a4f
Accession Number: edsdoj.6e638a980cc460c80185f7aa1148a4f
Database: Directory of Open Access Journals
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  Data: Annals of Clinical and Translational Neurology, Vol 11, Iss 2, Pp 466-476 (2024)
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  Data: Abstract Objectives To evaluate the clinical outcomes and relapse rates in neurosarcoidosis patients administered infliximab. Methods A systematic review was conducted using the MEDLINE, EMBASE, SCOPUS, and Cochrane Library databases. The search included studies from their inception to March 2023. We included case‐series studies with at least 10 neurosarcoidosis patients undergoing any treatment type. Studies were also required to report at least one of the following outcomes: response rate, overall survival rate, or relapse rate. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. A random‐effects model facilitated the analysis of proportional treatment outcomes. Study quality was evaluated using the modified Newcastle–Ottawa quality assessment scale, while a funnel plot helped detect any publication bias. Results Seven studies comprising 237 patients with neurosarcoidosis were included in the analysis. Of these patients, 184 (77.6%) received treatment with infliximab. The pooled proportion of patients showing clinical improvement after infliximab treatment was 0.74 (95% CI 0.64–0.84, I2 = 49.73%). Relapse rates, derived from four studies, stood at 0.38 (95% CI 0.22–0.55, I2 = 56.92%). Most studies reported successful tapering or cessation of corticosteroid dosage in patients receiving infliximab. Adverse effects were reported in 52 (29.4%) patients, of which 39 out of 54 events (72.2%) were linked to infections. Interpretation Infliximab demonstrated potential improvement in clinical outcomes for patients with refractory neurosarcoidosis and showed potential for reducing the dosage of concurrent corticosteroids. However, a degree of relapse was observed, with infections being the primary concern for adverse events.
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