ArticleJournal of neurology2025
Comparing the efficacy and safety of cyclophosphamide, infliximab and methotrexate in neurosarcoidosis: a multicenter retrospective study.
Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Neurosarcoidosis in Critical Care, Internal, and Pulmonary Medicine: A Practical Approach.Seminars in respiratory and critical care medicine · 2025Review
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionNeurosarcoidosis is a granulomatous disease affecting 10% of patients with sarcoidosis. In lack of standardized guidelines, various therapeutic strategies exist. Beyond corticosteroids, cyclophosphamide, infliximab, or methotrexate are available options. This study compared the efficacy and safety of these agents as firstline therapy.
methodsThis multicenter, retrospective, study included patients with definite or probable neurosarcoidosis (1999-2022). Primary endpoint was relapse rate at the end of follow-up, after first-line therapy with cyclophosphamide, infliximab or methotrexate. Relapse was defined as a≥1-point increase in the Extrapulmonary Organ Severity Tool score following initial improvement.
resultsFifty-two patients were included: 18 (34.6%) received cyclophosphamide, 10 (19.2%) infliximab and 24 (46.2%) methotrexate. Multivisceral impairment was observed in 63% of patients, and neurological involvement at diagnosis in 67% of patients. Main neurological localizations were the brain (60%), meninges (48%) and cranial nerves (46%). Sixteen patients (30.7%) relapsed: 56% with cyclophosphamide, 6% with infliximab and 38% with methotrexate (p = 0.06). Median relapse-free survival was 48 months in patients treated with cyclophosphamide, and not estimable for infliximab or methotrexate (p = 0.07). Relapse was associated with brain involvement (p = 0.006) and younger age (p = 0.04). At 12 months, response rate was 100% for infliximab-treated patients, 89% for cyclophosphamide and 87% for methotrexate. All treatments demonstrated a corticosteroid-sparing effect, with infliximab achieving the highest proportion of patients (80%) reaching ≤ 5 mg/day at 12 months (p = 0.07). Infections were more frequent with cyclophosphamide (p = 0.01), however two deadly infections occured with methotrexate.
conclusionInfliximab and methotrexate appear as effective and safe options for relapse prevention in neurosarcoidosis.
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