Friday, December 2, 2011

Anti-TNF Therapy in 15 Patients with Severe and Refractory Sarcoidosis

Inés Pérez-Martín and colleagues worked up retrospectively data on patients with sarcoidosis, who have been treated with TNF blockers. They found 15 patients. “Most patients had been refractory to corticosteroids and at least one immunosuppressive drug.” Three patients with neurosarcoidosis had been treated with corticosteroidsand TNF blockers as initial therapy. Complete clinical remission was achieved in nine patients. TNF blockers were evaluated as effective and safe in the management of severe and refractory sarcoidosis.
I am treating N=1 patient with neurosarcoidosis, with 3 mg infliximab per kg weight. Initial therapy had been high dose prednisolone without effect, but as adverse event diabetes with a ketoacidotic coma at bllod glucose levels above 800 mg/dl. The lesions in the brain (some near the optic nerve) shown on MRI regressed within a few months. I should mention that she has suffered from an intermittent Septicemia recently.

[TUE] 1968
Anti-TNF Therapy in 15 Patients with Severe and Refractory Sarcoidosis.
Inés Pérez-Martín1, Ricardo Blanco2, Javier Rueda1, Carmen Bejerano2, Orlando Pompei1, M. Carmen González-Vela1, Marcos A. González-López1, Héctor Fernández-Llaca1, Agustín Oterino1, María J. Sedano1, Mario Agudo1, Víctor M. Martínez-Taboada1 and Miguel Angel González-Gay1.
1Hospital Universitario Marqués de Valdecilla. IFIMAV, Santander, Spain, 2Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain
Conclusion: Infliximab and adalimumab appear to be effective and safe drugs in the management of severe and refractory sarcoidosis.

A second study by Eric Russell and colleagues showed equal results.

[TUE] 1975
Long Term Follow-up of Infliximab Efficacy in Pulmonary and Extrapulmonary Sarcoidosis Refractory to Conventional Therapy.
Eric Russell, Carolyn R. O’Connor and Humaira Hussain.
Drexel University College of Medicine, Philadelphia, PA
Conclusion: Infliximab is effective and well tolerated in long-term control of pulmonary and extrapulmonary symptoms in patients with sarcoidosis refractory to other agents or in whom other agents were poorly tolerated due to side effects.

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