Biologic Therapies in Sarcoidosis and Uveitis: A Review

Ogbue, Olisaemeka; Malhotra, Parul; Akku, Radhika; Jayaprakash, Thulasi Priya; Khan, Safeera

doi:10.7759/cureus.9057

Cited by 3 publications

(4 citation statements)

References 42 publications

(107 reference statements)

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“…135,136 Infliximab is similar to adalimumab in treatment response and safety. 137,138 Both infliximab and adalimumab have demonstrated success in patients with refractory chronic sarcoid uveitis that has failed to respond to at least one conventional immunosuppressive medication, resulting in improvement in inflammation including anterior chamber cell, vitreous haze, central macular thickness and reduction in corticosteroid dosing. 139,140 In rare cases, refractory to third-line therapy, rituximab and newer biologics including tocilizumab and Janus kinase (JAK) inhibitors, may be effective.…”

Section: Systemic Treatmentmentioning

confidence: 99%

“…Data from clinical trials have shown good effect with adalimumab for non‐infectious uveitis leading to significant reduction in risk of treatment failure and achieving steroid‐free disease quiescence 135,136 . Infliximab is similar to adalimumab in treatment response and safety 137,138 . Both infliximab and adalimumab have demonstrated success in patients with refractory chronic sarcoid uveitis that has failed to respond to at least one conventional immunosuppressive medication, resulting in improvement in inflammation including anterior chamber cell, vitreous haze, central macular thickness and reduction in corticosteroid dosing 139,140 …”

Section: Treatmentmentioning

confidence: 99%

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Insights into the diagnosis and management of sarcoid uveitis: A review

Samalia,

Lim,

Niederer

2024

Clinical Exper Ophthalmology

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Sarcoidosis is a leading cause of non‐infectious uveitis that commonly affects middle‐aged individuals and has a female preponderance. The disease demonstrates age, sex and ethnic differences in clinical manifestations. A diagnosis of sarcoidosis is made based on a compatible clinical presentation, supporting investigations and histologic evidence of non‐caseating granulomas, although biopsy is not always possible. Multimodal imaging with widefield fundus photography, optical coherence tomography and angiography can help in the diagnosis of sarcoid uveitis and in the monitoring of treatment response. Corticosteroid remains the mainstay of treatment; chronic inflammation requires steroid‐sparing immunosuppression. Features on multimodal imaging such as vascular leakage may provide prognostic indicators of outcome. Female gender, prolonged and severe uveitis, and posterior involving uveitis are associated with poorer visual outcomes.

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Section: Systemic Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Insights into the diagnosis and management of sarcoid uveitis: A review

Samalia,

Lim,

Niederer

2024

Clinical Exper Ophthalmology

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“…Moreover, monoclonal antibodies like infliximab, adalimumab, rituximab, and golimumab which are mostly prescribed to treat overactive immune systems may also be the drug of choice in many cases where a specific antibody is required to treat a specific antigen. Infliximab has been studied in randomized controlled trials and reported to possess beneficial effects on both pulmonary and extra-pulmonary sarcoidosis in a subgroup of carefully selected patients 38,39,40 .…”

Section: Fig 2: Structures Of Drugs Prescribed For Sarcoidosismentioning

confidence: 99%

“…This medicine is the first-line treatment in gout to treat joint pain associated with sarcoidosis. The major adverse effects related to the use of this drug are nausea, vomiting, diarrhea, and stomach cramps or pain 38 . CONCLUSION: However, sarcoidosis is a rare autoimmune inflammatory disease; an improvement in the cases of sarcoidosis has been seen in recent years, much research is unknown and going on.…”

Section: Fig 2: Structures Of Drugs Prescribed For Sarcoidosismentioning

confidence: 99%

Untitled

2021

IJPSR

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Sarcoidosis is a rare autoimmune inflammatory disease, which is difficult to diagnose due to a lack of approved clinical tests. It has been observed in each race, and highest among the Scandinavia, African-American but Asians are less vulnerable to it. It affects most prominently adults from the age group of 20 to 60. The main characterized symptom of this disease is non-caseating granulomas, specifically in the lungs and lymph nodes progressing to lungs impairment to pass oxygen, and finally total failure of lungs as well as heart. The main cause of sarcoidosis is immune irregularities in genetically predisposed individuals which manifests antigen(s) like microorganism or their products, due to an ex-aggregated immune response. There is no specific treatment available, although corticosteroids help in disappearing its symptoms. While more than 50 percent of the patients don"t require any treatment and illness goes on its own, only 10% require treatment in which severe symptoms developed and last long. The current review enlightens the pathogenesis of the disease, clinical indications, diagnostic evaluation, and various therapies for the treatment.

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Refractory multisystemic sarcoidosis, a diagnosis and treatment challenge: a case report

et al. 2023

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Background Sarcoidosis is a multisystemic granulomatous disease of unknown origin. It is characterized by abnormal activation of lymphocytes and macrophages with the formation of granulomas. Most cases have asymptomatic pulmonary involvement. In case of symptoms, they have an excellent response to glucocorticoid therapy. We present a case of sarcoidosis with multi-organ involvement, refractory to multiple treatments including biological. Partial remission was achieved in it. Case presentation We report an interesting case of a 38-years-old Spanish woman treated by Heerfordt’s syndrome (uveitis, parotiditis, fever and facial palsy) plus pulmonary hiliar adenopathy. A sarcoidosis diagnosis was confirmed by lung biopsy. She was initially treated with an 8 weeks course of medium dose oral glucocorticoids and tapered over 8 weeks with improvement. After the suspension of glucocorticoids a relapse occurs with severe ocular involvement and suspicion of neurological involvement. The patient received multiple lines of treatment with poor response. Finally, after the combination of cyclophosphamide with infliximab, the uveitis resolved, improving the neurological symptoms. Conclusions Sarcoidosis is a benign disease in most cases. In a small percentage of cases behaves aggressively, requiring early diagnosis and immunosuppressive treatment to avoid sequelae. An adequate immunosuppressive therapy based on Anti TNF drugs should be started to minimize damage and improve the quality of life.The choice of treatment depends on the type and severity of the disease.

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Biologic Therapies in Sarcoidosis and Uveitis: A Review

Cited by 3 publications

References 42 publications

Insights into the diagnosis and management of sarcoid uveitis: A review

Insights into the diagnosis and management of sarcoid uveitis: A review

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Refractory multisystemic sarcoidosis, a diagnosis and treatment challenge: a case report

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