Thalidomide for Recalcitrant Nodular Scleritis in Sarcoidosis

Huddleston, Stephen; Houser, Kourtney; Walton, R. Christopher

doi:10.1001/jamaophthalmol.2014.2420

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…112 In one case report, thalidomide was successfully used to treat cutaneous sarcoidosis and nodular scleritis in a patient who failed azathioprine and corticosteroid therapy. 113 Thalidomide is considered a sedative, hypnotic agent, but also has anti-inflammatory activity. It is under special regulations because it can cause severe congenital defects.…”

Section: Treatment Of Ocular Sarcoidosismentioning

confidence: 99%

Ocular Sarcoidosis

Pasadhika

Rosenbaum

2015

Clinics in Chest Medicine

219

185

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Sarcoidosis is one of the leading causes of inflammatory eye disease. Ocular sarcoidosis can involve any part of the eye and its adnexal tissues, and may cause uveitis, episcleritis/scleritis, eyelid abnormalities, conjunctival granuloma, optic neuropathy, lacrimal gland enlargement and orbital inflammation. Glaucoma and cataract can be complications from inflammation itself or adverse effects from therapy. Ophthalmic manifestations can be isolated, or associated with other organ involvement. Patients with ocular sarcoidosis can present with a wide range of clinical presentations and severity. Multi-disciplinary approaches are required to achieve the best treatment outcomes for both ocular and systemic manifestations.

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Section: Treatment Of Ocular Sarcoidosismentioning

confidence: 99%

Ocular Sarcoidosis

Pasadhika

Rosenbaum

2015

Clinics in Chest Medicine

219

185

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“…141,142 Some authors reported improved cutaneous and mucosal involvement under thalidomide. 143 Available data are still not sufficient to recommend using thalidomide in treating sarcoidosis even though case reports may be encouraging. New molecules similar to thalidomide, such as lenalidomide, may represent a well-tolerated alternative to thalidomide.…”

Section: Thalidomidementioning

confidence: 99%

<p>Refractory Sarcoidosis: A Review</p>

Jammal

Jamilloux

Gerfaud‐Valentin

et al. 2020

TCRM

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Sarcoidosis is a multi-system disease of unknown etiology characterized by granuloma formation in various organs (especially lung and mediastinohilar lymph nodes). In more than half of patients, the disease resolves spontaneously. When indicated, it usually responds to corticosteroids, the first-line treatment, but some patients may not respond or tolerate them. An absence of treatment response is rare and urges for verifying the absence of a diagnosis error, the good adherence of the treatment, the presence of active lesions susceptible to respond since fibrotic lesions are irreversible. That is when second-line treatments, immunosuppressants (methotrexate, leflunomide, azathioprine, mycophenolate mofetil, hydroxychloroquine), should be considered. Methotrexate is the only first-line immunosuppressant validated by a randomized controlled trial. Refractory sarcoidosis is not yet a well-defined condition, but it remains a real challenge for the physicians. Herein, we considered refractory sarcoidosis as a disease in which second-line treatments are not sufficient to achieve satisfying disease control or satisfying corticosteroids tapering. Tumor necrosis alpha inhibitors, third-line treatments, have been validated through randomized controlled trials. There are currently no guidelines or recommendations regarding refractory sarcoidosis. Moreover, criteria defining non-response to treatment need to be clearly specified. The delay to achieve response to organ involvement and drugs also should be defined. In the past ten years, the efficacy of several immunosuppressants beforehand used in other autoimmune or inflammatory diseases was reported in refractory cases series. Among them, anti-CD20 antibodies (rituximab), repository corticotrophin injection, and anti-JAK therapy anti-interleukin-6 receptor monoclonal antibody (tocilizumab) were the main reported. Unfortunately, no clinical trial is available to validate their use in the case of sarcoidosis. Currently, other immunosuppressants such as JAK inhibitors are on trial to assess their efficacy in sarcoidosis. In this review, we propose to summarize the state of the art regarding the use of immunosuppressants and their management in the case of refractory or multidrugresistant sarcoidosis.

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Thalidomide for Recalcitrant Nodular Scleritis in Sarcoidosis

Cited by 2 publications

References 6 publications

Ocular Sarcoidosis

Ocular Sarcoidosis

<p>Refractory Sarcoidosis: A Review</p>

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