Vorselaars et al identified factors associated with relapse of sarcoidosis following discontinuation of infliximab therapy. These can help to identify a patient who may benefit from more aggressive management. They can also help to identify a patient who may respond to a short course of therapy. The authors are from St. Antonius Hospital, University College Roosevelt, University Medical Centre Utrecht in The Netherlands.
Patient selection: severe, chronic sarcoidosis treated with infliximab (given to patients who were unresponsive to first or second line therapy or who had severe side effects)
Outcome: relapse of sarcoidosis after infliximab discontinued
Relapse occurred in 62% of patients with median time to relapse 11 months.
Predictors of relapse seen at the initiation of therapy:
(1) mediastinal SUVmax >= 6.0 on FDG PET (by multivariate analysis)
(2) serum soluble interleukin-2 receptor (sIL-2R) >= 4,000 pg per mL (by univariate analysis)
No predictors of relapse were identified at the time of treatment discontinuation.
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