Infliximab for the Treatment of Inflammatory Labyrinthitis: A Retrospective Cohort Study
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 insufficien...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/13/4350 |
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| author | Cassandre Djian Karine Champion Nicolas Lai Ludovic Drouet Blanca Amador Borrero Audrey Depond Stéphane Mouly Clément Jourdaine Philippe Herman Michael Eliezer Charlotte Hautefort Damien Sène |
| author_facet | Cassandre Djian Karine Champion Nicolas Lai Ludovic Drouet Blanca Amador Borrero Audrey Depond Stéphane Mouly Clément Jourdaine Philippe Herman Michael Eliezer Charlotte Hautefort Damien Sène |
| author_sort | Cassandre Djian |
| collection | DOAJ |
| description | 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; <i>p</i> = 0.027), SRT (54 ± 37 db versus 66 ± 32 db; <i>p</i> = 0.041) and DHI score (27 ± 15 versus 9 ± 2; <i>p</i> = 0.032) significantly improved. After the 6-month treatment period, the mean CS dose decreased from 38 ± 33 to 6 ± 5 mg/day (<i>p</i> = 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. |
| first_indexed | 2024-03-11T01:37:06Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T01:37:06Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
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| spelling | doaj.art-69bf220af5484442b053c4f200f467a02023-11-18T16:52:36ZengMDPI AGJournal of Clinical Medicine2077-03832023-06-011213435010.3390/jcm12134350Infliximab for the Treatment of Inflammatory Labyrinthitis: A Retrospective Cohort StudyCassandre Djian0Karine Champion1Nicolas Lai2Ludovic Drouet3Blanca Amador Borrero4Audrey Depond5Stéphane Mouly6Clément Jourdaine7Philippe Herman8Michael Eliezer9Charlotte Hautefort10Damien Sène11Department of Otolaryngology, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, 75010 Paris, FranceDepartment of Internal Medicine, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, 75010 Paris, FranceDepartment of Otolaryngology, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, 75010 Paris, FranceDepartment of Internal Medicine, Saint Joseph Hospital, 75014 Paris, FranceDepartment of Internal Medicine, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, 75010 Paris, FranceDepartment of Internal Medicine, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, 75010 Paris, FranceDepartment of Internal Medicine, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, 75010 Paris, FranceDepartment of Otolaryngology, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, 75010 Paris, FranceDepartment of Otolaryngology, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, 75010 Paris, FranceDepartment of Neuroradiology, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, 75010 Paris, FranceDepartment of Otolaryngology, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, 75010 Paris, FranceDepartment of Internal Medicine, Hôpital Lariboisière, Assistance Publique—Hôpitaux de Paris, 75010 Paris, FranceInflammatory 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; <i>p</i> = 0.027), SRT (54 ± 37 db versus 66 ± 32 db; <i>p</i> = 0.041) and DHI score (27 ± 15 versus 9 ± 2; <i>p</i> = 0.032) significantly improved. After the 6-month treatment period, the mean CS dose decreased from 38 ± 33 to 6 ± 5 mg/day (<i>p</i> = 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.https://www.mdpi.com/2077-0383/12/13/4350inflammatory labyrinthitisinfliximabhearing disordersvestibular diseases |
| spellingShingle | Cassandre Djian Karine Champion Nicolas Lai Ludovic Drouet Blanca Amador Borrero Audrey Depond Stéphane Mouly Clément Jourdaine Philippe Herman Michael Eliezer Charlotte Hautefort Damien Sène Infliximab for the Treatment of Inflammatory Labyrinthitis: A Retrospective Cohort Study Journal of Clinical Medicine inflammatory labyrinthitis infliximab hearing disorders vestibular diseases |
| title | Infliximab for the Treatment of Inflammatory Labyrinthitis: A Retrospective Cohort Study |
| title_full | Infliximab for the Treatment of Inflammatory Labyrinthitis: A Retrospective Cohort Study |
| title_fullStr | Infliximab for the Treatment of Inflammatory Labyrinthitis: A Retrospective Cohort Study |
| title_full_unstemmed | Infliximab for the Treatment of Inflammatory Labyrinthitis: A Retrospective Cohort Study |
| title_short | Infliximab for the Treatment of Inflammatory Labyrinthitis: A Retrospective Cohort Study |
| title_sort | infliximab for the treatment of inflammatory labyrinthitis a retrospective cohort study |
| topic | inflammatory labyrinthitis infliximab hearing disorders vestibular diseases |
| url | https://www.mdpi.com/2077-0383/12/13/4350 |
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