Daniel G. Arkfeld, MD
Potential Financial Conflicts of Interest: None disclosed.
Arkfeld D.; How Is Infliximab Harmful?. Ann Intern Med. 2008;148:166. doi: 10.7326/0003-4819-148-2-200801150-00014
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Published: Ann Intern Med. 2008;148(2):166.
TO THE EDITOR:
In reading Hoffman and colleagues' (1) article on infliximab for glucocorticoid-induced remission of giant cell arteritis (GCA), I was surprised to see the conclusion statement of “ … [infliximab] is of no benefit and may be harmful.” I could find no evidence of harm or injury in the study patients and thought it was unfortunate that the sponsor ended the study prematurely. Of additional intrigue is the use of the same conclusion in the following article on infliximab plus prednisone or placebo for polymyalgia rheumatica, by Salvarani and colleagues (2), which similarly concluded that “ … [infliximab] is of no benefit and may be harmful.” Could the authors clarify this issue of “harm”? As stated in Hoffman and colleagues' article, the treatment of refractory GCA is an area where no proven options are available, and one may be forced to use novel agents. Unfortunately, trials of methotrexate, azathioprine, and other agents have not shown benefit. Because our first rule in the Hippocratic Oath is to do no harm, one may not consider infliximab in GCA despite a lack of evidence of any potential injury presented in the results of the article.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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