학술논문
Infliximab for the Treatment of Inflammatory Labyrinthitis: A Retrospective Cohort Study.
Document Type
Academic Journal
Author
Djian C; Department of Otolaryngology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France.; Champion K; Department of Internal Medicine, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France.; Lai N; Department of Otolaryngology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France.; Drouet L; Department of Internal Medicine, Saint Joseph Hospital, 75014 Paris, France.; Amador Borrero B; Department of Internal Medicine, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France.; Depond A; Department of Internal Medicine, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France.; Mouly S; Department of Internal Medicine, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France.; Faculté de Médecine, Paris Cité University, 75006 Paris, France.; Jourdaine C; Department of Otolaryngology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France.; Herman P; Department of Otolaryngology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France.; Faculté de Médecine, Paris Cité University, 75006 Paris, France.; Eliezer M; Department of Neuroradiology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France.; Hautefort C; Department of Otolaryngology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France.; Sène D; Department of Internal Medicine, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France.; Faculté de Médecine, Paris Cité University, 75006 Paris, France.
Source
Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2077-0383
Abstract
Inflammatory labyrinthitis is defined as a fluctuant vestibulo-cochlear syndrome associated with an impairment of the blood-labyrinthine barrier (BLB) on delayed FLAIR MRI sequences. Systemic and intratympanic corticosteroids are the gold standard treatment but their effect is frequently insufficient. The objective is here to determine whether infliximab could be of value in the treatment of bilateral inflammatory labyrinthitis. A retrospective monocentric study was conducted between January 2013 and December 2021. All patients included in the study were affected with a bilateral vestibulo-cochlear syndrome associated with bilateral blood-labyrinthine barrier impairment. Patients were administered infliximab at the dose of 5 mg/kg every 6 weeks for 6 months. Audiometry, MRI with delayed FLAIR sequences on the labyrinth, and corticosteroid doses still required were assessed both before and after treatment with infliximab was completed. Pure-tone average (PTA) was the primary outcome. The secondary outcomes were the speech recognition threshold (SRT), the Dizziness Handicap Inventory (DHI) score, and the corticosteroid (CS) dose. A total of nine patients including five men and four women were enrolled in the study. Thirteen ears were analyzed. After a 6-month period of treatment, the mean PTA (54 ± 24 db versus 66 ± 22 db; p = 0.027), SRT (54 ± 37 db versus 66 ± 32 db; p = 0.041) and DHI score (27 ± 15 versus 9 ± 2; p = 0.032) significantly improved. After the 6-month treatment period, the mean CS dose decreased from 38 ± 33 to 6 ± 5 mg/day ( p = 0.003). We conclude that infliximab substantially improves the vestibulo-cochlear function in patients with bilateral inflammatory labyrinthitis and could be of value in corticosteroid-dependent cases.