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Effectiveness of Infliximab in Patients with Complex Regional Pain Syndrome: A Case Series

PURPOSE: Complex regional pain syndrome (CRPS) is a multi-mechanism disease, with an exaggerated inflammatory response as an important underlying mechanism. Auto-inflammation can theoretically be combated by anti-inflammatories, such as TNF-α inhibitors. This study’s aim was to assess the effectiven...

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Autores principales: van den Berg, Corinne, Dirckx, Maaike, Huygen, Frank J P M, Tiemensma, Jitske
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10257428/
https://www.ncbi.nlm.nih.gov/pubmed/37303693
http://dx.doi.org/10.2147/JPR.S408858
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author van den Berg, Corinne
Dirckx, Maaike
Huygen, Frank J P M
Tiemensma, Jitske
author_facet van den Berg, Corinne
Dirckx, Maaike
Huygen, Frank J P M
Tiemensma, Jitske
author_sort van den Berg, Corinne
collection PubMed
description PURPOSE: Complex regional pain syndrome (CRPS) is a multi-mechanism disease, with an exaggerated inflammatory response as an important underlying mechanism. Auto-inflammation can theoretically be combated by anti-inflammatories, such as TNF-α inhibitors. This study’s aim was to assess the effectiveness of intravenous infliximab, a TNF-α inhibitor, in patients with CRPS. PATIENTS AND METHODS: CRPS patients treated with infliximab between January 2015 and January 2022 were approached to participate in this retrospective study. Medical records were screened for age, gender, medical history, CRPS duration, and CRPS severity score. Additionally, treatment effect, dose and duration, and side effects were extracted from medical records. Patients who still receive infliximab completed a short global perceived effect survey. RESULTS: Eighteen patients received infliximab, and all but two gave consent. Trial treatment with three sessions of 5 mg/kg intravenous infliximab was completed in 15 patients (93.7%). Eleven patients (73.3%) were categorized as responders with a positive treatment effect. Treatment was continued in nine patients, and seven patients are currently treated. Infliximab dose is 5 mg/kg, and frequency is every four to six weeks. Seven patients completed a global perceived effect survey. All patients reported improvement (median 2, IQR 1–2) and treatment satisfaction (median 1, IQR 1–2). One patient described side effects such as itching and rash. CONCLUSION: Infliximab proved effective in 11 out of 15 CRPS patients. Seven patients are still being treated. Further research is needed on the role of infliximab in the treatment of CRPS and possible predictors of response to treatment.
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spelling pubmed-102574282023-06-11 Effectiveness of Infliximab in Patients with Complex Regional Pain Syndrome: A Case Series van den Berg, Corinne Dirckx, Maaike Huygen, Frank J P M Tiemensma, Jitske J Pain Res Original Research PURPOSE: Complex regional pain syndrome (CRPS) is a multi-mechanism disease, with an exaggerated inflammatory response as an important underlying mechanism. Auto-inflammation can theoretically be combated by anti-inflammatories, such as TNF-α inhibitors. This study’s aim was to assess the effectiveness of intravenous infliximab, a TNF-α inhibitor, in patients with CRPS. PATIENTS AND METHODS: CRPS patients treated with infliximab between January 2015 and January 2022 were approached to participate in this retrospective study. Medical records were screened for age, gender, medical history, CRPS duration, and CRPS severity score. Additionally, treatment effect, dose and duration, and side effects were extracted from medical records. Patients who still receive infliximab completed a short global perceived effect survey. RESULTS: Eighteen patients received infliximab, and all but two gave consent. Trial treatment with three sessions of 5 mg/kg intravenous infliximab was completed in 15 patients (93.7%). Eleven patients (73.3%) were categorized as responders with a positive treatment effect. Treatment was continued in nine patients, and seven patients are currently treated. Infliximab dose is 5 mg/kg, and frequency is every four to six weeks. Seven patients completed a global perceived effect survey. All patients reported improvement (median 2, IQR 1–2) and treatment satisfaction (median 1, IQR 1–2). One patient described side effects such as itching and rash. CONCLUSION: Infliximab proved effective in 11 out of 15 CRPS patients. Seven patients are still being treated. Further research is needed on the role of infliximab in the treatment of CRPS and possible predictors of response to treatment. Dove 2023-06-06 /pmc/articles/PMC10257428/ /pubmed/37303693 http://dx.doi.org/10.2147/JPR.S408858 Text en © 2023 van den Berg et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
van den Berg, Corinne
Dirckx, Maaike
Huygen, Frank J P M
Tiemensma, Jitske
Effectiveness of Infliximab in Patients with Complex Regional Pain Syndrome: A Case Series
title Effectiveness of Infliximab in Patients with Complex Regional Pain Syndrome: A Case Series
title_full Effectiveness of Infliximab in Patients with Complex Regional Pain Syndrome: A Case Series
title_fullStr Effectiveness of Infliximab in Patients with Complex Regional Pain Syndrome: A Case Series
title_full_unstemmed Effectiveness of Infliximab in Patients with Complex Regional Pain Syndrome: A Case Series
title_short Effectiveness of Infliximab in Patients with Complex Regional Pain Syndrome: A Case Series
title_sort effectiveness of infliximab in patients with complex regional pain syndrome: a case series
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10257428/
https://www.ncbi.nlm.nih.gov/pubmed/37303693
http://dx.doi.org/10.2147/JPR.S408858
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