Biologic and advanced immunomodulating therapeutic options for sarcoidosis: a clinical update

Ndili, Ogugua; Lower, Elyse E.; Baughman, Robert P.

doi:10.1080/17512433.2021.1878024

Cited by 11 publications

(13 citation statements)

References 364 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since tumor necrosis factor (TNF) is being produced within granuloma, anti-TNF drugs can be used in treatment of sarcoidosis. The treatment whit infliximab and adalimumab have shown promising results, and there are studies which test other monoclonal antibodies, however there is still a great need for further clinical trials and experience with these treatments [18,19].…”

Section: The Best Treatment?mentioning

confidence: 99%

Neurosarcoidosis - an ever-present clinical challenge

et al. 2021

View full text Add to dashboard Cite

Sarcoidosis afflicts the central nervous system more frequently than previously believed. Neurological symptoms are present in roughly a half of patients, and depend of the location in central nervous system. The probability of spontaneous regression is significantly less when compared to other forms of sarcoidosis, which means that the proper diagnosis and treatment is paramount. Even when properly treated, functional defects are not uncommon. Majority of these patients require immunomodulating drugs and continuous follow-up. New immunomodulating drugs, especially biological agents, have shown to be significantly more effective, with fewer side effects, and are important when corticosteroids could not be applied. Less invasive methods, such as cerebrospinal analysis, help greatly in the diagnostics procedure, and require further research and improvement

show abstract

Section: The Best Treatment?mentioning

confidence: 99%

Neurosarcoidosis - an ever-present clinical challenge

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Failures (including SCD) may occur in patients with CS despite high dose steroids [199,200]. IA has an important adjunctive role in CS, not only for steroid-sparing properties but may also enhance effi cacy [29,30]. A variety of IA and Disease Modifying Anti-Rheumatic Agents (DMARA) have been used to treat pulmonary and extra-pulmonary sarcoidosis (including steroid-recalcitrant cases) [27,30,31,[217][218][219][220][221].…”

Section: Therapy For Cs: Role Of Immunosuppressive Agents (Ias)mentioning

confidence: 99%

“…These trials were stopped due to lack of benefi t (i.e., clinical status, death, or hospitalization for CHF) and a black box warning against TNF- antagonists exists for patients with CHF. However, TNF- is a key mediator of infl ammation and granuloma formation in sarcoidosis [30], so there is a strong rationale to use TNF- antagonists in cases of sarcoidosis failing standard therapy. Importantly, several non-randomized trials in pulmonary [230] and extra-pulmonary sarcoidosis refractory to steroids or IA reported favorable responses to TNF- antagonists [particularly infl iximab and adalimumab (ADA)] [32,227,[231][232][233].…”

Section: Tumor Necrosis Factor Alpha (Tnf-α) Antagonistsmentioning

confidence: 99%

“…However, etanercept was ineffective as therapy for progressive pulmonary sarcoidosis [235] or chronic ocular sarcoidosis [236]. Further, etanercept has a higher incidence of paradoxical sarcoid-like reactions compared to other TNF--antagonists and is not recommended [30]. While IFX may be the most effi cacious agent in this class, ADA can be substituted in patients experiencing adverse effects with IFX [237].…”

Section: Tumor Necrosis Factor Alpha (Tnf-α) Antagonistsmentioning

confidence: 99%

“…As will be discussed in detail later, steroids have been associated with favorable responses in large retrospective trials of CS [23][24][25] but failures or relapses have led to the use of Immunosuppressive Agents (IA) [26], usually in addition to steroids [27][28][29]. Further, given the possible role of tumor necrosis factor-a (TNF-) in the pathogenesis of sarcoidosis [30], TNF- antagonists have been used to treat CS, usually in cases failing steroids or other IA [31][32][33][34]. However, data regarding the use of (TNF-) antagonists are even more limited than steroids or IA.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cardiac involvement in sarcoidosis: Evolving concepts in diagnosis and treatment

P¹,

C²,

S³

et al. 2021

J Cardiovasc Med Cardiol

View full text Add to dashboard Cite

Clinically evident cardiac involvement has been noted in at least 2 to 7% of patients with sarcoidosis, but occult involvement is much higher (> 20%). Cardiac Sarcoidosis (CS) is often not recognized as an antemortem, as sudden death may be the presenting feature. Cardiac involvement may occur at any point during the course of sarcoidosis and may occur in the absence of pulmonary or systemic involvement. Sarcoidosis can involve any part of the heart. The prognosis of CS is related to the extent and site(s) of involvement. Most deaths due to CS are due to arrhythmias or conduction defects, but granulomatous infiltration of the myocardium may cause progressive and ultimately lethal cardiomyopathy. The definitive diagnosis of isolated CS is difficult and the yield of Endomyocardial Biopsies (EMB) is low. Treatment of CS is often warranted even in the absence of histologic proof. Radionuclide scans are integral to the diagnosis. Gadolinium-enhanced cardiac magnetic imaging scans and 18Fluorodeoxyglucose (18FDG)-Positron Emission Tomography (PET) are the key imaging modalities to diagnose CS. The prognosis of CS is variable, but mortality rates of untreated CS are high. Randomized therapeutic trials have not been done, but corticosteroids (alone or combined with additional immunosuppressive agents) are the mainstay of therapy. Additionally, anti-arrhythmic agents and therapy for heart failure are often required. Because of the potential for sudden cardiac death, an Implantable Cardioverter-Defibrillator (ICD) should be placed in any patient with CS and serious ventricular arrhythmias or heart block and should be considered for cardiomyopathy. Cardiac transplantation is a viable option for patients with end-stage CS refractory to medical therapy.

show abstract

The Evolving Landscape of Cutaneous Sarcoidosis: Pathogenic Insight, Clinical Challenges, and New Frontiers in Therapy

Imadojemu

Caplan

2022

Am J Clin Dermatol

View full text Add to dashboard Cite

Biologic and advanced immunomodulating therapeutic options for sarcoidosis: a clinical update

Cited by 11 publications

References 364 publications

Neurosarcoidosis - an ever-present clinical challenge

Neurosarcoidosis - an ever-present clinical challenge

Cardiac involvement in sarcoidosis: Evolving concepts in diagnosis and treatment

The Evolving Landscape of Cutaneous Sarcoidosis: Pathogenic Insight, Clinical Challenges, and New Frontiers in Therapy

Contact Info

Product

Resources

About