Adalimumab successful in sarcoidosis patients with refractory chronic non-infectious uveitis

Erckens, Roel J.; Mostard, Rémy L M; Wijnen, Petal A.; Schouten, Jan S. A. G.; Drent, Marjolein

doi:10.1007/s00417-011-1844-0

Cited by 157 publications

(75 citation statements)

References 37 publications

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“…The patients were screened for the presence of uveitis, as described previously [23]. In addition, fluorescein angiography or optical coherence tomography was performed to detect the presence of vasculitis, papillitis or macular oedema, as described previously ( fig.…”

Section: Evaluation Of Uveitismentioning

confidence: 99%

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Association of the TNF-α G-308A polymorphism with TNF-inhibitor response in sarcoidosis

et al. 2014

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Responsiveness to tumour necrosis factor (TNF) inhibitors has been associated with the TNF-a G-308A polymorphism in rheumatoid arthritis. The aim of this study was to examine the association between the presence of this polymorphism and the response to TNF inhibitors in patients with refractory sarcoidosis.Patients (n5111) who started TNF-inhibitor treatment (76 infliximab, 35 adalimumab) were followed for at least 1 year. The main symptoms in these patients were fatigue (n5100, 90.1%), small fibre neuropathy (n591, 82.0%), pulmonary involvement (n569, 62.2%), and/or uveitis (n531, 27.9%). Patients were additionally genotyped for the presence of the TNF-a G-308A polymorphism. Treatment response was assessed using clinical outcome measures and questionnaires.Three-quarters (n583, 74.8%) of the patients responded well. Of the patients without the variant A-allele 93.6% (73 out of 78, p,0.001) improved, while 30.3% (10 out of 33) of variant A-allele carriers responded favourably to TNF inhibitors. For patients with the GG-genotype, the probability of improving compared with remaining stable or deteriorating was three times higher (risk ratio 3.09, 95% CI 1. 84-5.20).Sarcoidosis patients without the TNF-a -308A variant allele (GG-genotype) had a three-fold higher response to TNF inhibitors (adalimumab or infliximab). Further research is needed to evaluate the value of genotyping for the TNF-a G-308A polymorphism in order to tailor TNF-inhibitor treatment. @ERSpublications TNF-a G-308A polymorphism predicts TNF-inhibitor response in refractory sarcoidosis: a step to personalised medicine?

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Section: Evaluation Of Uveitismentioning

confidence: 99%

“…In addition, fluorescein angiography or optical coherence tomography was performed to detect the presence of vasculitis, papillitis or macular oedema, as described previously ( fig. 2) [23].…”

Section: Evaluation Of Uveitismentioning

confidence: 99%

Association of the TNF-α G-308A polymorphism with TNF-inhibitor response in sarcoidosis

et al. 2014

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“…Since both sarcoidosis and Crohn's disease are granulomatous conditions, it seems logical to follow the regimen developed for Crohn's disease. Several open label studies have employed a higher dose of adalimumab [56,92,93]. These studies have reported an improvement with treatment.…”

Section: Anti-tnf Agentsmentioning

confidence: 99%

Established and experimental medical therapy of pulmonary sarcoidosis

et al. 2013

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The treatment options for pulmonary sarcoidosis have increased over the past 10 years. As new treatments have been introduced, the best way to assess and compare treatments remains unknown. The goal of this review is to discuss the standard treatments for pulmonary sarcoidosis, including glucocorticoids, and cytotoxic agents, such as methotrexate, azathioprine and leflunomide, and compare them to the newer biological agents, such as infliximab and adalimumab. We also discuss some novel treatments which are currently being evaluated. To compare these different regimens, we look at the measures used to assess response. These include pulmonary function, chest imaging, steroid sparing potential and, more recently, improvements in quality of life measures. While there is, as yet, no standard assessment for response, there is a growing consensus that response to treatment may include improvement of one or more of the following: forced vital capacity, chest imaging and steroid sparing. Several drugs used for pulmonary sarcoidosis have demonstrated improvement in one or more of these measures.

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“…52 Foi também utilizado com sucesso em doentes com uveíte crónica não-infecciosa. 53 Deve ser considerado em doentes que foram tratados com sucesso com infliximab, mas que desenvolveram anticorpos.…”

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Sarcoidose

Luz

Fernandes

Cardoso

2016

SPDV

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RESUMO -A sarcoidose consiste numa doença inflamatória multissistémica, de etiologia desconhecida, que se caracteriza pela formação de granulomas não-caseosos nos órgãos envolvidos, predominantemente pulmões e gânglios intratorácicos. O envolvimento cutâneo ocorre em cerca de 25-35% dos casos, é habitualmente um achado precoce e constitui um local acessível e seguro para estudo histológico. As lesões cutâneas podem ter várias apresentações, incluindo pápulas, nódulos, placas e cicatrizes infiltradas. O diagnósti-co baseia-se no reconhecimento das características clínicas, imagiológicas e histológicas e exclusão de outras doenças granulomatosas. O diagnóstico precoce e tratamento sistémico (quando necessário) poderão prevenir complicações futuras. PALAVRAS-CHAVE -Doenças da Pele; Granuloma; Sarcoidose. Sarcoidosis ABSTRACT -Sarcoidosis is an inflammatory multisystemic disease of unknown etiology, which is characterized by the formation of noncaseating granulomas in the organs involved, mainly lungs and intrathoracic lymph nodes. Skin involvement occurs in 25- INTRODUÇÃOA sarcoidose consiste numa doença inflamatória de envolvimento sistémico, que se caracteriza pela formação de granulomas não-caseosos nos órgãos envolvidos. Afecta tipicamente adultos jovens. Em mais de 90% dos casos há envolvimento pulmonar, no entanto esta patologia pode afectar virtualmente qualquer órgão/sistema.A sua etiologia não é conhecida, contudo pensa-se que existe uma tendência genética adquirida para o desenvolvimento de resposta imunológica aquando de exposição a determinadas partículas, contribuindo para a lesão orgânica.A sintomatologia pode ser muito variável, dependendo dos órgãos envolvidos.Ao longo dos últimos anos têm surgido novos avanços na compreensão da sarcoidose. O presente artigo pretende sumarizar e rever os recentes avanços e conhecimentos desta patologia, nomeadamente no que diz respeito à etiopatogénese, características clinico-patológicas, diagnóstico e tratamento. Neste sentido, foi feita uma revisão da literatura, baseada em bases de dados, como o PubMed, bem como em livros de dermatologia. A revisão da literatura incluiu ainda a pesquisa de artigos nas referências bibliográficas de estudos analisados. Foram seleccionados artigos publicados em português, inglês ou espanhol, de acordo com o conteú-do do título e/ou resumo.

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Adalimumab successful in sarcoidosis patients with refractory chronic non-infectious uveitis

Cited by 157 publications

References 37 publications

Association of the TNF-α G-308A polymorphism with TNF-inhibitor response in sarcoidosis

Association of the TNF-α G-308A polymorphism with TNF-inhibitor response in sarcoidosis

Established and experimental medical therapy of pulmonary sarcoidosis

Sarcoidose

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