To report results of treatment with a monoclonal antibody (infliximab) directe d against tumor necrosis factor α.in seven patients with chronic and difficult -to-control idiopathic orbital inflammation (orbital myositis). Observational case series. Retrospective data were collected from seven patients who had idiop athic orbital inflammation and who were evaluated at three medical centers. All patients were treated with infliximab after the failure of traditional therapy, which included corticosteroids, radiotherapy, or anti-inflammatory chemotherape utic agents. All seven patients had a favorable response to treatment with infli ximab. One patient with Behc.et disease required supplemental oral corticosteroi ds. Pain, swelling, and need for concomitant corticosteroids were the primary me asures of treatment success. Symptoms of comorbid disease in four patients also improved (Crohn disease in two, Behcet disease in one, and psoriasis in one). Th ere were no untoward effects of treatment after a mean follow-up of 15.7 months (range, 4 to 31 months). Treatment with infliximab appears to offer another th erapeutic option in cases of recalcitrant or recurrent idiopathic orbital inflam mation in which conventional treatment fails.
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