Abstract
Sarcoidosis is an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. Sarcoidosis most often occurs between 20 and 40 years of age, with women being diagnosed more frequently than men. Corticosteroids is the first-line treatment; other treatment options include Methotrexate, Azathioprine, Leflunomide, Mycophenolate mofetil. Tumor necrosis factor-alpha (TNF-α) plays an important role in sarcoidosis and can be a potential therapeutic target. Newer therapeutic targets include inhibition of CTLA 4, IL-12/23, IL/17 pathway, MAPK, NLRP3 inflammasome and ubiquitin proteasome system. This chapter highlights the etiopathogenesis of Sarcoidosis and biologic treatments in current use and the potential future applications of newer agents and those under development.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Valeyre D, Prasse A, Nunes H, et al. Sarcoidosis Lancet. 2014;383:1155–67.
James DG, Sharma OP. From Hutchinson to now: a historical glimpse. Curr Opin Pulm Med. 2002;8:416–23.
Sharma OP. Sarcoidosis around the world. Clin Chest Med. 2008;29:357–63.
Baughman RP, Grutters JC. New treatment strategies for pulmonary sarcoidosis: antimetabolites, biological drugs, and other treatment approaches. Lancet Respir Med. 2015;3:813–23.
Zissel G, Prasse A, Müller-Quernheim J. Immunologic response of sarcoidosis. Semin Respir Crit Care Med. 2010;31:390–403.
Grutters JC, Van den Bosch JM. Corticosteroid treatment in sarcoidosis. Eur Respir J. 2006;28:627–36.
Baughman RP, Winget DB, Lower EE. Methotrexate is steroid sparing in acute sarcoidosis: results of a double blind, randomized trial. Sarcoidosis Vasc Diffuse Lung Dis. 2000;17:60–6.
Baughman RP, Lower EE. A clinical approach to the use of methotrexate for sarcoidosis. Thorax. 1999;54:742–6.
Baughman RP, Lower EE. Medical therapy of sarcoidosis. Semin Respir Crit Care Med. 2014;35:391–406.
Baughman RP, Lower EE. Leflunomide for chronic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2004;21:43–8.
Androdias G, Maillet D, Marignier R. Mycophenolate mofetil may be effective in CNS sarcoidosis but not in sarcoid myopathy. Neurology. 2011;76:1168–72.
Doherty CB, Rosen T. Evidence-based therapy for cutaneous sarcoidosis. Drugs. 2008;68:1361–83.
Baughman RP, Lower EE. Infliximab for refractory sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2001;18:70–4.
Baughman RP, Drent M, Kavuru M. Infliximab therapy in patients with chronic sarcoidosis and pulmonary involvement. Am J Respir Crit Care Med. 2006;174:795–802.
Crouser ED, Lozanski G, Fox CC, et al. The CD4+ lymphopenic sarcoidosis phenotype is highly responsive to anti-tumor necrosis factor-{alpha} therapy. Chest. 2010;137:1432–5.
Field S, Regan AO, Sheahan K, at al. Recalcitrant cutaneous sarcoidosis responding to adalimumab but not to etanercept. Clin Exp Dermatol. 2010;35:795–6.
Sweiss NJ, Noth I, Mirsaeidi M, et al. Efficacy results of a 52-week trial of adalimumab in the treatment of refractory sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2014;31:46–54.
Baughman RP, Judson MA, Ingledue R, et al. Efficacy and safety of apremilast in chronic cutaneous sarcoidosis. Arch Dermatol. 2012;148:262–4.
Park MK, Fontana BH, et al. Steroid-sparing effects of pentoxifylline in pulmonary sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2009;26:121–31.
Sandborn WJ, Colombel J-F, Sands BE, et al. Abatacept for Crohn’s disease and ulcerative colitis. Gastroenterology. 2012;143:62e4–69.e4.
Moller DR, Forman JD, Liu MC, et al. Enhanced expression of IL-12 associated with Th1 cytokine profiles in active pulmonary sarcoidosis. J Immunol. 1996;156:4952–60.
Judson MA, Baughman RP, Costabel U, et al. Safety and efficacy of ustekinumab or golimumab in patients with chronic sarcoidosis. Eur Respir J. 2014;44:1296–307.
Fazzi P, Manni E, Cristofani R, et al. Thalidomide for improving cutaneous and pulmonary sarcoidosis in patients resistant or with contraindications to corticosteroids. Biomed Pharmacother. 2012;66:300–7.
Bomprezzi R, Pati S, Chansakul C, et al. A case of neurosarcoidosis successfully treated with rituximab. Neurology. 2010;75:568–70.
Schreiber S, Feagan B, D’Haens G, et al. Oral p38 mitogen-activated protein kinase inhibition with BIRB 796 for active Crohn’s disease: a randomized, double-blind, placebo-controlled trial. Clin Gastroenterol Hepatol. 2006;4:325–34.
Dotan I, Rachmilewitz D, Schreiber S, et al. A randomised placebo-controlled multicentre trial of intravenous semapimod HCl for moderate to severe Crohn’s disease. Gut. 2010;59:760–6.
Shao BZ, Xu ZQ, Han BZ, et al. NLRP3 inflammasome and its inhibitors: a review. Front Pharmacol. 2015;6:262.
Weathington NM, Sznajder JI, Mallampalli RK. The emerging role of the ubiquitin proteasome in pulmonary biology and disease. Am J Respir Crit Care Med. 2013;188:530–7.
Lohr NJ, Molleston JP, Strauss KA, et al. Human ITCH E3 ubiquitin ligase deficiency causes syndromic multisystem autoimmune disease. Am J Hum Genet. 2010;86:447–53.
Teicher BA, Tomaszewski JE. Proteasome inhibitors. Biochem Pharmacol. 2015;96:1–9.
Cremers JP, Drent M, Bast A, et al. Multinational evidence-based world association of sarcoidosis and other granulomatous disorders recommendations for the use of methotrexate in sarcoidosis. Curr Opin Pulm Med. 2013;19:545–61.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Chaturvedi, V., Gupta, M. (2022). Biologics in Sarcoidosis. In: Jain, N., Duggal, L. (eds) Handbook of Biologics for Rheumatological Disorders. Springer, Singapore. https://doi.org/10.1007/978-981-16-7200-2_22
Download citation
DOI: https://doi.org/10.1007/978-981-16-7200-2_22
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-16-7199-9
Online ISBN: 978-981-16-7200-2
eBook Packages: MedicineMedicine (R0)