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Infliximab in patients with systemic vasculitis that is difficult to treat: poor outcome and significant adverse effects
  1. Shirish R Sangle,
  2. Graham R V Hughes,
  3. David P D’Cruz
  1. Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital London, London, UK
  1. Correspondence to:
    Dr David P D’Cruz
    Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital London, London SE1 7EH, UK;david.d’cruz{at}kcl.ac.uk

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The traditional treatment of systemic vasculitides with long-term oral cyclophosphamide (CPM) and high-dose corticosteroids has given way to more conservative approaches with shorter induction with CPM, followed by maintenance treatment with azathioprine or methotrexate.1 Despite this, 30–50% of patients relapse by 12 months. Endothelial dysfunction and tumour necrosis factor (TNF) α play a major part in pathogenesis.2 Raised TNF levels are associated with vascular damage and correlate with disease activity.

We describe an open-label uncontrolled prospective study of anti-TNFα (infliximab), in the management of patients with systemic vasculitides who failed to maintain remission on conventional immunosuppressive treatment.

We prospectively …

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