Biologic therapies in the treatment of sarcoidosis.
Sarcoidosis is a disease of remarkable heterogeneity in organ manifestation, severity and natural history, characterized by the presence of non-caseating granulomas. The majority of cases are acute and self-limited or remit with short courses of glucocorticoids; however, a proportion progress to a life-threatening obliterative fibrotic type associated with significant disability related to pulmonary, cardiac, ocular or central nervous system involvement. Biologic agents have been demonstrated in the successful treatment of refractory organ-threatening sarcoidosis; and though sarcoidosis remains elusive in predictability of progression, strong evidence suggests an indisputably efficacious role for these agents in efforts to stave morbidity and mortality related to sarcoidosis. This paper provides a review of sarcoidosis mechanistic etiopathogenesis to highlight the hypothetical underpinnings of the utility and concerns of current biologic treatments in current use and the potential future applications of newer agents and those under development.
a New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, University Medical Center Comprehensive Pulmonary Hypertension Center , Tulane University Lung Center , New Orleans , LA , USA.
Lesley Ann
LA
Saketkoo
b Department of Medicine , University of Cincinnati Medical Center , Cincinnati , OH , USA.
Robert P
RP
Baughman
D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001691:Biological Therapy; D002986:Clinical Trials as Topic; D006801:Humans; D016219:Immunotherapy, Adoptive / Q000379:methods*; D018664:Interleukin-12 / Q000276:immunology; D053759:Interleukin-23 / Q000276:immunology; D000069283:Rituximab / Q000627:therapeutic use; D012507:Sarcoidosis / Q000276:immunology / Q000628:therapy*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology / Q000637:transplantation*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
D000911:Antibodies, Monoclonal; D053759:Interleukin-23; D014409:Tumor Necrosis Factor-alpha; D018664:Interleukin-12; D000069283:Rituximab
Infliximab; adalimumab. etanercept; methotrexate; sarcoidosis; tumor necrosis factor