Intratympanic infliximab is a safe and effective rescue therapy for refractory immune-mediated hearing loss

Purpose To determine the efficacy and safety of the intratympanic infiltration of infliximab at the hearing threshold of patients in follow-up for refractory immune-mediated hearing loss. Methods 17 patients were collected with relapses, despite maintenance treatment with oral azathioprine associated or not with oral prednisone at low doses (between 5 and 7.5 ml/day) or refractory relapses to previous intratympanic corticoid treatment being 19 affected ears infiltrated. We measured the hearing threshold by Pure-Tone Average (PTA) 500–3000 Hz, 125–8000 Hz and 250–8000 Hz in pre-infiltration (baseline) and follow-up 3 weeks post-infiltration with auditory threshold at frequencies 125–8000 Hz. Results The average age was 50.68 years (±15.23 years). After the administration of intratympanic infliximab, an improvement of the hearing threshold was showed in the Pure-Tone Average (PTA) calculated at 500–3000 Hz ( p = 0.004), 125–8000 Hz ( p = 0.001) and 250–8000 Hz ( p = 0.006). An immediate improvement in low frequencies also was observed: 125, 250 and 500 Hz ( p = 0.009, p = 0.002 and p