Infliximab in neurosarcoidosis: a systematic review and meta-analysis
Issued Date
2023-01-01
Resource Type
eISSN
23289503
Scopus ID
2-s2.0-85179357620
Journal Title
Annals of Clinical and Translational Neurology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Annals of Clinical and Translational Neurology (2023)
Suggested Citation
Chaiyanarm S. Infliximab in neurosarcoidosis: a systematic review and meta-analysis. Annals of Clinical and Translational Neurology (2023). doi:10.1002/acn3.51968 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/91539
Title
Infliximab in neurosarcoidosis: a systematic review and meta-analysis
Author(s)
Author's Affiliation
Other Contributor(s)
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.