Etanercept for the Treatment of Stage II and III Progressive Pulmonary Sarcoidosis

Utz, James P.; Limper, Andrew H.; Kalra, Sumit; Specks, Ulrich; Scott, John; Vuk-Pavlović, Zvezdana; Schroeder, Darrell R.

doi:10.1378/chest.124.1.177

Cited by 350 publications

(171 citation statements)

References 26 publications

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“…One small phase II trial of etanercept in the treatment of pulmonary sarcoidosis was initiated, but terminated early because of excessive treatment failures. However, 5 of 17 subjects were considered treatment successes [42]. Similar results were seen in a recent study involving 18 patients with ocular sarcoidosis.…”

Section: -Sarcoidosissupporting

confidence: 68%

Off-Label Dermatological Uses of Etanercept Treatment

2016

J turk acad dermatol

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Background: Tumor necrosis factor-alpha (TNF-α) is a proinflammatory cytokine that plays an immunomodulatory role in a variety of systemic and dermatologic disease. Its blockade can be achieved by using specific inhibitors like etanercept. At present, etanercept is approved for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis and psoriasis treatment. However, it has been used with promising results in other inflammatory dermatoses. Etanercept treatment have been reported in the following dermatologic diseases: sarcoidosis, hidradenitis suppurativa, acne vulgaris, cicatricial pemphigoid, pemphigus vulgaris, Hailey-Hailey disease, Behçet' s disease, oral aphthous stomatitis, pyoderma gangrenosum, multicentric reticulohistiocytosis, apthous stomatitis, Sneddon-Wilkinson disease, acrodermatitis continua of Hallopeau, SAPHO syndrome, pityriasis rubra pilaris, vitiligo, necrobiosis lipoidica, silicone granulomas, Sweet's syndrome, atopic dermatitis, dyshidrotic eczema, toxic epidermal necrolysis, alopecia areata, centrifugal annular erythema, primary amyloidosis, erythroderma-related pruritus in Sézary syndrome, cutaneous T-cell lymphoma, inflammatory linear verrucous epidermal nevus, excessive scarring, postherpetic neuralgia, dermatomyositis, vasculitis, lupus erythematosus, and scleroderma. The vast majority of these reports are in the form of individual case reports and small case series. A growing number of published reports suggest that etanercept treatment may be effective in the treatment of numerous inflammatory skin disease outside their currently approved indications.

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Section: -Sarcoidosissupporting

confidence: 68%

Off-Label Dermatological Uses of Etanercept Treatment

2016

J turk acad dermatol

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“…First, the limited clinical data available suggests that not all TNF-a antagonists are equally effective for sarcoidosis. In particular, etanercept has not been found to be particularly effective for various forms of sarcoidosis [41,42] and has not been recommended for this condition [43]. Although limited data are available concerning the benefit of adalimumab for the treatment of sarcoidosis, it appears to require high dosing (administered subcutaneously) and to be administered over a longer period of time to maximize the benefit in comparison to infliximab, which is administered intravenously [43].…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of ustekinumab or golimumab in patients with chronic sarcoidosis

et al. 2014

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Sarcoidosis is characterised by non-caseating granulomas that secrete pro-inflammatory cytokines, including interleukin (IL)-12, IL-23, and tumour necrosis factor (TNF)-a. Ustekinumab and golimumab are monoclonal antibodies that specifically inhibit IL-12/IL-23 and TNF-a, respectively.Patients with chronic pulmonary sarcoidosis (lung group) and/or skin sarcoidosis (skin group) received either 180 mg ustekinumab at week 0 followed by 90 mg every 8 weeks, 200 mg golimumab at week 0 followed by 100 mg every 4 weeks, or placebo. Patients underwent corticosteroid tapering between weeks 16 and 28. The primary end-point was week 16 change in percentage predicted forced vital capacity (DFVC % pred) in the lung group. Major secondary end-points were: week 28 for DFVC % pred, 6-min walking distance, St George's Respiratory Questionnaire (lung group), and Skin Physician Global Assessment response (skin group).At week 16, no significant differences were observed in DFVC % pred with ustekinumab (-0.15, p50.13) or golimumab (1.15, p50.54) compared with placebo (2.02). At week 28, there were no significant improvements in the major secondary end-points, although a nonsignificant numerically greater Skin Physician Global Assessment response was observed following golimumab treatment (53%) when compared with the placebo (30%). Serious adverse events were similar in all treatment groups.Although treatment was well tolerated, neither ustekinumab nor golimumab demonstrated efficacy in pulmonary sarcoidosis. However, trends towards improvement were observed with golimumab in some dermatological end-points. @ERSpublicationsNeither ustekinumab nor golimumab demonstrated efficacy for the treatment of patients with pulmonary sarcoidosis

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“…28 This study from the Mayo Clinic was terminated before completion because of a lack of response or worsening symptoms of patients with stage II/III sarcoidosis with etanercept therapy. The explanation for worsening of a granulomatous disease with etanercept therapy is unclear.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary lymphohistiocytic reactions temporally related to etanercept therapy

Yousem

Đačić

2005

Modern Pathology

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This report details the pulmonary pathologic findings in four patients with rheumatoid arthritis, who developed new onset of pulmonary signs and symptoms with alveolar infiltrates temporally related to the institution of etanercept therapy. Biopsy findings showed an interstitial and air space lymphohistiocytic infiltrate with nonnecrotizing granulomas, in the setting of negative cultures and special stains for microorganisms. The association with etanercept therapy and granulomatous reactions is discussed along with the differential diagnosis.

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Etanercept for the Treatment of Stage II and III Progressive Pulmonary Sarcoidosis

Cited by 350 publications

References 26 publications

Off-Label Dermatological Uses of Etanercept Treatment

Off-Label Dermatological Uses of Etanercept Treatment

Safety and efficacy of ustekinumab or golimumab in patients with chronic sarcoidosis

Pulmonary lymphohistiocytic reactions temporally related to etanercept therapy

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