Der Hautarzt

, Volume 64, Issue 10, pp 757–761

Off-label-Anwendung von Infliximab



Der Tumornekrosefektor α (TNF) ist ein proinflammatorisches Zytokin und ein zentraler Entzündungsfaktor. Etliche TNFα-Antagonisten werden therapeutisch eingesetzt, darunter Infliximab, ein chimärer monoklonaler Antikörper mit Anti-TNFα-Aktivität. Zahlreiche Studien haben gezeigt, dass TNFα-Antagonisten in der Behandlung von Psoriasis – besonders bei schweren resistenten Formen – und Arthritis wirksam sind. Ferner wurden einige Kasuistiken und Studien zu TNFα bei neuen dermatologischen Indikationen publiziert. Ziel des Übersichtsartikels ist es, neue Off-label-Anwendungen von Infliximab anhand veröffentlichter Daten zusammenzufassen.


Tumornekrosefaktor α Antagonist Monoklonaler Antikörper Inflammation Zytokin 

Off-label use of infliximab


Tumor necrosis factor α (TNFα) is a pro-inflammatory cytokine and a key mediator of inflammation. Several TNFα antagonists have been used therapeutically. One of them, infliximab, is a chimeric monoclonal antibody with anti-TNFα activity. Numerous studies have shown TNFα antagonists to be effective in treating psoriasis—particularly severe resistant forms—and arthritis. Additionally, several case reports and studies showing the effects of TNFα on new dermatologic indications have been published. The intention of this review is to summarize the new off-label uses of infliximab according to published data.


Tumor necrosis factor α Antagonist Monoclonal antibody Inflammation Cytokine 

Supplementary material

105_2013_2596_MO1_ESM.pdf (474 kb)
Englische Version: Off-label-Anwendung von Infliximab (PDF475 KB)


  1. 1.
    Adişen E, Oztaş M, Gürer MA (2008) Treatment of idiopathic pyoderma gangrenosum with infliximab: induction dosing regimen or on-demand therapy? Dermatology 216(2):163–165CrossRefPubMedGoogle Scholar
  2. 2.
    Adnot-Desanlis L, Antonicelli F, Tabary T et al (2013) Effectiveness of infliximab in pityriasis rubra pilaris is associated with pro-inflammatory cytokine inhibition. Dermatology 226(1):41–46CrossRefPubMedGoogle Scholar
  3. 3.
    Almoallim H, Al-Ghamdi Y, Almaghrabi H, Alyasi O (2012) Anti-tumor necrosis factor-α induced systemic lupus erythematosus. Open Rheumatol J 6:315−319CrossRefPubMedGoogle Scholar
  4. 4.
    Alokaily F, Alsaleh S, Al-Balawi M, Al-Rashidi S (2010) Efficacy of infliximab on the acute attack of uveitis. Saudi Med J 31(1):82-85PubMedGoogle Scholar
  5. 5.
    Aringer M, Houssiau F, Gordon C et al (2009) Adverse events and efficacy of TNF-alpha blockade with infliximab in patients with systemic lupus erythematosus: long-term follow-up of 13 patients. Rheumatology (Oxford) 48(11):1451–1454Google Scholar
  6. 6.
    Atzeni F, Sarzi-Puttini P, Doria A et al (2005) Potential off-label use of infliximab in autoimmune and non-autoimmune diseases: a review. Autoimmun Rev 4(3):144–152CrossRefPubMedGoogle Scholar
  7. 7.
    Barde C, Laffitte E, Campanelli A et al (2011) Intralesional infliximab in noninfectious cutaneous granulomas: three cases of necrobiosis lipoidica. Dermatology 222(3):212–226CrossRefPubMedGoogle Scholar
  8. 8.
    Barth D, Harth W, Treudler R, Simon JC (2009) Successful treatment of pityriasis rubra pilaris (type 1) under combination of infliximab and methotrexate. J Dtsch Dermatol Ges 7(12):1071–1074PubMedGoogle Scholar
  9. 9.
    Brooklyn TN, Dunnill MG, Shetty A, Bowden JJ et al (2006) Infliximab for the treatment of pyoderma gangrenosum: a randomised, double blind, placebo controlled trial. Gut 55(4):505-9CrossRefPubMedGoogle Scholar
  10. 10.
    Cemil BC, Atas H, Canpolat F et al (2013) Infliximab-induced discoid lupus erythematosus. Lupus 22(5):515–518CrossRefPubMedGoogle Scholar
  11. 11.
    Chan WP, Lee HS (2012) Combination therapy with infliximab and methotrexate in recalcitrant mucocutaneous Behçet disease. Cutis 89(4):185–190PubMedGoogle Scholar
  12. 12.
    Chen D, Wang XB, Zhou Y, Zhu XC (2013) Efficacy of infliximab in the treatment for dermatomyositis with acute interstitial pneumonia: a study of fourteen cases and literature review. Rheumatol Int Google Scholar
  13. 13.
    Couriel DR, Saliba R, Lima M de et al (2009) A phase III study of infliximab and corticosteroids for the initial treatment of acute graft-versus-host disease. Biol Blood Marrow Transplant 15(12):1555–1562CrossRefPubMedGoogle Scholar
  14. 14.
    Diab M, Coloe JR, Magro C, Bechtel MA (2010) Treatment of recalcitrant generalized morphea with infliximab. Arch Dermatol 146(6):601–604CrossRefPubMedGoogle Scholar
  15. 15.
    Díaz-Ley B, Guhl G, Fernández-Herrera J (2007) Off-label use of biologic agents in the treatment of dermatosis, part 1: infliximab and adalimumab. Actas Dermosifiliogr 98(10):657–678CrossRefPubMedGoogle Scholar
  16. 16.
    Doherty CB, Rosen T (2008) Evidence-based therapy for cutaneous sarcoidosis. Drugs 68(10):1361-1383CrossRefPubMedGoogle Scholar
  17. 17.
    García-Rabasco A, Alsina-Gibert M, Pau-Charles I, Iranzo P (2012) Infliximab therapy failure in two patients with pemphigus vulgaris. J Am Acad Dermatol 67(5):196–197CrossRefGoogle Scholar
  18. 18.
    Garcovich S, Di Giampetruzzi AR, Antonelli G et al (2010) Treatment of refractory adult-onset pityriasis rubra pilaris with TNF-alpha antagonists: a case series. J Eur Acad Dermatol Venereol 24(8):881–884CrossRefPubMedGoogle Scholar
  19. 19.
    Grant A, Gonzalez T, Montgomery MO et al (2010) Infliximab therapy for patients with moderate to severe hidradenitis suppurativa: a randomized, double-blind, placebo-controlled crossover trial. J Am Acad Dermatol 62:205–217CrossRefPubMedGoogle Scholar
  20. 20.
    Hertl MS, Haendle I, Schuler G, Hertl M (2005) Rapid improvement of recalcitrant disseminated granuloma annulare upon treatment with the tumour necrosis factor-alpha inhibitor, infliximab. Br J Dermatol 152(3):552–555CrossRefPubMedGoogle Scholar
  21. 21.
    Hostettler KE, Studler U, Tamm M, Brutsche MH (2012) Long-term treatment with infliximab in patients with sarcoidosis. Respiration 83(3):218-24CrossRefPubMedGoogle Scholar
  22. 22.
    Jacobi A, Shuler G, Hertl M (2005) Rapid control of therapy-refractory pemphigus vulgaris by treatment with the tumour necrosis factor-alpha inhibitor infliximab. Br J Dermatol 153(2):448–449CrossRefPubMedGoogle Scholar
  23. 23.
    Kanemaru H, Makino T, Jinnin M et al (2013) Case of neuro-Behçet’s disease successfully maintained a remission using infliximab for 2 years. J DermatolGoogle Scholar
  24. 24.
    Kolde G, Muche JM, Schulze P et al (2003) Infliximab: a promising new treatment option for ulcerated necrobiosis lipoidica. Dermatology 206(2):180–181CrossRefPubMedGoogle Scholar
  25. 25.
    Lu R, George SJ, Hsu S (2006) Pityriasis rubra pilaris: failure of combination treatment with acitretin and infliximab. Dermatol Online J 12(4):18PubMedGoogle Scholar
  26. 26.
    Magro-Checa C, Salvatierra J, Rosales-Alexander JL et al (2013) Life-threatening vasculo-Behçet following discontinuation of infliximab after three years of complete remission. Clin Exp RheumatolGoogle Scholar
  27. 27.
    Mang R, Ruzicka T, Stege H (2004) Therapy for severe necrotizing vasculitis with infliximab. J Am Acad Dermatol 51(2):321–322CrossRefPubMedGoogle Scholar
  28. 28.
    Markomichelakis N, Delicha E, Masselos S, Fragiadaki K, Kaklamanis P, Sfikakis PP(2011)A single infliximab infusion vs corticosteroids for acute panuveitis attacks in Behçet’s disease: a comparative 4-week study. Rheumatology (Oxf) 50(3):593-597Google Scholar
  29. 29.
    Matzkies FG, Manger B, Schmitt-Haendle M et al (2003) Severe septicaemia in a patient with polychondritis and Sweet’s syndrome after initiation of treatment with infliximab. Ann Rheum Dis 62(1):81–82CrossRefPubMedGoogle Scholar
  30. 30.
    Meyerle JH, Shorr A (2003) The use of infliximab in cutaneous sarcoidosis. J Drugs Dermatol 2(4):413–414PubMedGoogle Scholar
  31. 31.
    Meziane L, Caudron A, Dhaille F et al (2012) Febrile ulceronecrotic Mucha-Habermann disease: treatment with infliximab and intravenous immunoglobulins and review of the literature. Dermatology 225(4):344–348CrossRefPubMedGoogle Scholar
  32. 32.
    Mrowietz U, Reich K (2009) Ten years of infliximab: its role in dermatology. Eur J Pharmacol 623 (Suppl 1):S10–S16CrossRefPubMedGoogle Scholar
  33. 33.
    Patriarca F, Sperotto A, Damiani D et al (2004) Infliximab treatment for steroid-refractory acute graft-versus-host disease. Haematologica 89(11):1352–1359PubMedGoogle Scholar
  34. 34.
    Roddy E, Courtney PA, Morris A (2002) Non-Hodgkin’s lymphoma in a patient with refractory dermatomyositis which had been treated with infliximab. Rheumatology (Oxford) 41(10):1194–1195Google Scholar
  35. 35.
    Rott S, Mrowietz U (2007) The use of infliximab in dermatology. J Dtsch Dermatol Ges 5(8):655–660CrossRefPubMedGoogle Scholar
  36. 36.
    Scott-Lang V, Tidman M, McKay D (2012) Toxic epidermal necrolysis in a child successfully treated with infliximab. Pediatr Dermatol (Epub ahead print)Google Scholar
  37. 37.
    Sfikakis PP, Markomichelakis N, Alpsoy E et al (2007) Anti-TNF therapy in the management of Behc¸et’s disease—review and basis for recommendations. Rheumatology (Oxford) 46:736–741Google Scholar
  38. 38.
    Shirakawa M, Uramoto K, Harada FA (2011) Treatment of acne conglobata with infliximab. J Am Acad Dermatol 55(2):344-6CrossRefGoogle Scholar
  39. 39.
    Streit M, Beleznay Z, Braathen LR (2006) Topical application of the tumour necrosis factor-alpha antibody infliximab improves healing of chronic wounds. Int Wound J 3:171–179CrossRefPubMedGoogle Scholar
  40. 40.
    Takayama K, Ishikawa S, Enoki T et al (2013) Successful treatment with infliximab for Behçet disease during pregnancy. Ocul Immunol Inflamm 21(4):321–323CrossRefPubMedGoogle Scholar
  41. 41.
    Toker E, Kazokoğlu H, Acar N( 2002) High dose intravenous steroid therapy for severe posterior segment uveitis in Behçet’s disease.Br J Ophthalmol 86(5):521-523CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Hautärzte und Laserzentrum LandauDeutschland
  2. 2.Universität“Carol Davila” BukarestBukarestRumänien
  3. 3.Universität BernBernSchweiz
  4. 4.Universität OsnabrückOsnabrückDeutschland
  5. 5.Medizinische FakultätGazi Universität AnkaraAnkaraTürkei

Personalised recommendations