ArticleNeurology2025
Effectiveness of Infliximab for Refractory Nonischemic Cerebral Enhancing Foreign-Body Granulomatous Lesions After Endovascular Therapy.
Article in Neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectivesNonischemic cerebral enhancing (NICE) foreign-body granulomatous lesions are an immune-mediated complication of endovascular therapy (EVT). No single immunotherapy has demonstrated consistent effectiveness. We highlight the novel use of tumor necrosis factor (TNF)-α inhibition in treating refractory NICE lesions.
methodsThis multicenter case series describes 3 patients with refractory NICE lesions (recurrent seizures, persistent MRI enhancement, and/or steroid dependence with failure of ≥1 maintenance immunotherapy) treated with infliximab. Their clinical course, evaluation, and outcomes are detailed.
resultsPatients were women (median age 57 years [range 56-58]), presenting with headache and seizures within 6 months of EVT for intracranial aneurysm (n = 2) or carotid stenosis (n = 1). MRI (n = 3) revealed unilateral nodular enhancement with vasogenic edema, and brain biopsy (n = 2) revealed foreign-body granulomatous inflammation. All patients developed refractory disease and steroid dependence despite ≥1 immunotherapy including mycophenolate (n = 3), rituximab (n = 1), and/or cyclophosphamide (n = 1). Infliximab treatment resulted in significant clinical and radiologic improvement in all 3 patients. DISCUSSION: TNF-α inhibition may be an effective targeted treatment strategy for NICE foreign-body granulomatous lesions, expanding treatment options for patients with refractory disease. Larger prospective studies are needed to establish treatment guidelines aimed at improving outcomes in individuals with refractory disease. CLASSIFICATION OF EVIDENCE: This article provides Class IV evidence that infliximab may offer potential benefit in patients with NICE lesions after EVT.
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