Current and emerging pharmacological treatments for sarcoidosis: A review

Drug Design, Development and Therapy

Volumn 7, Issue , 2013, Pages 325-338

  Beegle, Scott H ^a   Barba, Kerry ^a   Gobunsuy, Romel ^a   Judson, Marc A ^a  

^a ALBANY MEDICAL COLLEGE   (United States)

Author keywords

Corticosteroids; Drugs; Extrapulmonary sarcoidosis; Pulmonary sarcoidosis; Treatment

Indexed keywords

ADALIMUMAB; ANTIMALARIAL AGENT; AZATHIOPRINE; BUDESONIDE; CHLOROQUINE; CORTICOSTEROID; CYCLOPHOSPHAMIDE; CYCLOSPORIN; FOLIC ACID; GAMMA INTERFERON; HYDROXYCHLOROQUINE; INFLIXIMAB; LEFLUNOMIDE; METHOTREXATE; METHYLPREDNISOLONE SODIUM SUCCINATE; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; PLACEBO; PREDNISOLONE; PREDNISONE; TRIAMCINOLONE ACETONIDE; TUMOR NECROSIS FACTOR ALPHA;

ABDOMINAL PAIN; AGRANULOCYTOSIS; ALOPECIA; ANEMIA; ANTIINFLAMMATORY ACTIVITY; ARTHRITIS; ASYMPTOMATIC DISEASE; BEHAVIOR CHANGE; BLOOD TOXICITY; CATARACT; CLINICAL DECISION MAKING; CONTINUOUS INFUSION; CORTICOSTEROID THERAPY; CYTOPENIA; DIARRHEA; DISEASE ACTIVITY; DRESS SYNDROME; DRUG CARCINOGENICITY; DRUG CONTRAINDICATION; DRUG DOSE COMPARISON; DRUG DOSE ESCALATION; DRUG DOSE REDUCTION; DRUG ERUPTION; DRUG FEVER; DRUG HALF LIFE; DRUG HYPERSENSITIVITY; DRUG MEGADOSE; DRUG PENETRATION; DRUG WITHDRAWAL; ENZYME REPRESSION; GASTROINTESTINAL SYMPTOM; GLAUCOMA; GRANULOMA; HEMOLYSIS; HUMAN; HYPERCALCEMIA; HYPERCALCIURIA; HYPERCHOLESTEROLEMIA; HYPERGLYCEMIA; HYPERTRANSAMINASEMIA; IMMUNE DEFICIENCY; IMMUNOMODULATION; INTERSTITIAL PNEUMONIA; LEUKOPENIA; LIVER FIBROSIS; LIVER TOXICITY; LOADING DRUG DOSE; LONG TERM CARE; LUNG TOXICITY; MAINTENANCE DRUG DOSE; MALAISE; METABOLIC DISORDER; MONOTHERAPY; MOOD CHANGE; MULTIPLE ORGAN FAILURE; NAUSEA; OPPORTUNISTIC INFECTION; OPTIC NEURITIS; OSTEOPOROSIS; PATIENT MONITORING; PERIPHERAL NEUROPATHY; RANDOMIZED CONTROLLED TRIAL (TOPIC); RETINOPATHY; REVIEW; SARCOIDOSIS; SIDE EFFECT; SKIN TOXICITY; TREATMENT DURATION; TREATMENT INDICATION; TREATMENT OUTCOME; TREATMENT RESPONSE; UROGENITAL TRACT DISEASE; UVEITIS; VOMITING; WEIGHT GAIN;

CORTICOSTEROIDS; DRUGS; EXTRAPULMONARY SARCOIDOSIS; PULMONARY SARCOIDOSIS; TREATMENT;

CHRONIC DISEASE; GLUCOCORTICOIDS; HUMANS; SARCOIDOSIS; TIME FACTORS;

EID: 84876264413     PISSN: 11778881     EISSN: None     Source Type: Journal    
DOI: 10.2147/DDDT.S31064     Document Type: Review

References (89)

1. Hunninghake GW, Costabel U, Ando M, et al. ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and other Granulomatous Disorders. Sarcoidosis Vasc Diffuse Lung Dis. 1999;16(2):149-173.
2. Judson MA. An approach to the treatment of pulmonary sarcoidosis with corticosteroids: the six phases of treatment. Chest. 1999;115(4):1158-1165.
3. Judson MA. The treatment of pulmonary sarcoidosis. Respir Med. 2012;106(10):1351-1361.
4. Ohara K, Judson MA, Baughman RP. Clinical aspects of ocular sarcoidosis. Eur Respir Mon. 2005;10:188-209.
5. Rosen Y. Pathology of sarcoidosis. Semin Respir Crit Care Med. 2007;28(1):36-52.
6. Bell NH, Stern PH, Pantzer E, Sinha TK, DeLuca HF. Evidence that increased circulating 1 alpha, 25-dihydroxyvitamin D is the probable cause for abnormal calcium metabolism in sarcoidosis. J Clin Invest. 1979;64(1):218-225.
7. Burke RR, Rybicki BA, Rao DS. Calcium and vitamin D in sarcoidosis: how to assess and manage. Semin Respir Crit Care Med. 2010;31(4):474-484.
8. Sharma OP. Renal sarcoidosis and hypercalcemia. Eur Respir Mon. 2005;32:220-232.
9. Smedema JP, Snoep G, van Kroonenburgh MP, et al. Cardiac involvement in patients with pulmonary sarcoidosis assessed at two university medical centers in The Netherlands. Chest. 2005;128(1):30-35.
10. Judson MA, Gilbert GE, Rodgers JK, Greer CF, Schabel SI. The utility of the chest radiograph in diagnosing exacerbations of pulmonary sarcoidosis. Respirology. 2008;13(1):97-102.
11. Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med. 2007;357(21):2153-2165.
12. Grutters JC, van den Bosch JM. Corticosteroid treatment in sarcoidosis. Eur Respir J. 2006;28(3):627-636.
13. Schutt AC, Bullington WM, Judson MA. Pharmacotherapy for pulmonary sarcoidosis: a Delphi consensus study. Respir Med. 2010; 104(5):717-723.
14. Baughman RP, Iannuzzi MC, Lower EE, et al. Use of fluticasone in acute symptomatic pulmonary sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2002;19(3):198-204.
15. Pietinalho A, Tukiainen P, Haahtela T, Persson T, Selroos O. Early treatment of stage II sarcoidosis improves 5-year pulmonary function. Chest. 2002;121(1):24-31.
16. Gottlieb JE, Israel HL, Steiner RM, Triolo J, Patrick H. Outcome in sarcoidosis. The relationship of relapse to corticosteroid therapy. Chest. 1997;111(3):623-631.
17. Eule H, Weinecke A, Roth I, Wuthe H. The possible influence of corticosteroid therapy on the natural course of pulmonary sarcoidosis. Late results of a continuing clinical study. Ann N Y Acad Sci. 1986;465:695-701.
18. Izumi T. Sarcoidosis in Kyoto (1963-1986). Sarcoidosis. 1988;5(2):142-146.
19. Rodrigues SC, Rocha NA, Lima MS, et al. Factor analysis of sarcoidosis phenotypes at two referral centers in Brazil. Sarcoidosis Vasc Diffuse Lung Dis. 2011;28(1):34-43.
20. Paramothayan NS, Lasserson TJ, Jones PW. Corticosteroids for pulmonary sarcoidosis. Cochrane Database Syst Rev. 2005;2:CD001114.
21. Baughman RP, Lower EE, Kaufman AH. Ocular sarcoidosis. Semin Respir Crit Care Med. 2010;31(4):452-462.
22. Nunes H, Freynet O, Naggara N, et al. Cardiac sarcoidosis. Semin Respir Crit Care Med. 2010;31(4):428-441.
23. Yazaki Y, Isobe M, Hiroe M, et al. Prognostic determinants of long-term survival in Japanese patients with cardiac sarcoidosis treated with prednisone. Am J Cardiol. 2001;88(9):1006-1010.
24. Hamzeh NY, Wamboldt FS, Weinberger HD. Management of cardiac sarcoidosis in the United States: a Delphi study. Chest. 2012;141(1):154-162.
25. Lower EE, Broderick JP, Brott TG, Baughman RP. Diagnosis and management of neurological sarcoidosis. Arch Intern Med. 1997;157(16):1864-1868.
26. Zajicek JP, Scolding NJ, Foster O, et al. Central nervous system sarcoidosis-diagnosis and management. QJM. 1999;92(2):103-117.
27. Sharma OP. Neurosarcoidosis: a personal perspective based on the study of 37 patients. Chest. 1997;112(1):220-228.
28. Marchell RM, Judson MA. Cutaneous sarcoidosis. Semin Respir Crit Care Med. 2010;31(4):442-451.
29. Haimovic A, Sanchez M, Judson MA, Prystowsky S. Sarcoidosis: a comprehensive review and update for the dermatologist: part I. Cutaneous disease. J Am Acad Dermatol. 2012;66(5):699. e691-e618; quiz 717-698.
30. Lazar CA, Culver DA. Treatment of sarcoidosis. Semin Respir Crit Care Med. 2010;31(4):501-518.
31. Baughman RP, Drent M, Kavuru M, et al. Infliximab therapy in patients with chronic sarcoidosis and pulmonary involvement. Am J Respir Critl Care Med. 2006;174(7):795-802.
32. Lower EE, Baughman RP. Prolonged use of methotrexate for sarcoidosis. Arch Intern Med. 1995;155(8):846-851.
33. Baughman RP, Costabel U, du Bois RM. Treatment of sarcoidosis. Clin Chest Med. 2008;29(3):533-548, ix-x.
34. Baughman RP, Culver DA, Judson MA. A concise review of pulmonary sarcoidosis. Am J Respir Crit Care Med. 2011;183(5):573-581.
35. Morgan SL, Baggott JE, Vaughn WH, et al. Supplementation with folic acid during methotrexate therapy for rheumatoid arthritis. A double-blind, placebo-controlled trial. Ann Intern Med. 1994;121(11):833-841.
36. Kalia S, Dutz JP. New concepts in antimalarial use and mode of action in dermatology. Dermatol Ther. 2007;20(4):160-174.
37. Baltzan M, Mehta S, Kirkham TH, Cosio MG. Randomized trial of prolonged chloroquine therapy in advanced pulmonary sarcoidosis. Am Journal Respir Crit Care Med. 1999;160(1):192-197.
38. Jones E, Callen JP. Hydroxychloroquine is effective therapy for control of cutaneous sarcoidal granulomas. J Am Acad Dermatol. 1990;23(3 Pt 1):487-489.
39. Adams JS, Diz MM, Sharma OP. Effective reduction in the serum 1,25-dihydroxyvitamin D and calcium concentration in sarcoidosis-associated hypercalcemia with short-course chloroquine therapy. Ann Internal Med. 1989;111(5):437-438.
40. Barre PE, Gascon-Barre M, Meakins JL, Goltzman D. Hydroxychloroquine treatment of hypercalcemia in a patient with sarcoidosis undergoing hemodialysis. Am J Med. 1987;82(6):1259-1262.
41. O'Leary TJ, Jones G, Yip A, Lohnes D, Cohanim M, Yendt ER. The effects of chloroquine on serum 1,25-dihydroxyvitamin D and calcium metabolism in sarcoidosis. N Engl J Med. 1986;315(12):727-730.
42. Sweiss NJ, Patterson K, Sawaqed R, et al. Rheumatologic manifestations of sarcoidosis. Semin Respir Crit Care Med. 2010;31(4):463-473.
43. Baughman RP, Lower EE. Steroid-sparing alternative treatments for sarcoidosis. Clin Chest Med. 1997;18(4):853-864.
44. Ruckemann K, Fairbanks LD, Carrey EA, et al. Leflunomide inhibits pyrimidine de novo synthesis in mitogen-stimulated T-lymphocytes from healthy humans. J Biol Chem. 1998;273(34):21682-21691.
45. Sahoo DH, Bandyopadhyay D, Xu M, et al. Effectiveness and safety of leflunomide for pulmonary and extrapulmonary sarcoidosis. Eur Respir J. 2011;38(5):1145-1150.
46. Baughman RP, Lower EE. Leflunomide for chronic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2004;21(1):43-48.
47. Smolen JS, Emery P, Kalden JR, et al. The efficacy of leflunomide monotherapy in rheumatoid arthritis: towards the goals of disease modifying antirheumatic drug therapy. J Rheumatol Suppl. 2004;71:13-20.
48. Emery P, Breedveld FC, Lemmel EM, et al. A comparison of the efficacy and safety of leflunomide and methotrexate for the treatment of rheumatoid arthritis. Rheumatology (Oxford). 2000;39(6):655-665.
49. van Riel PL, Smolen JS, Emery P, et al. Leflunomide: a manageable safety profile. J Rheumatol Suppl. 2004;71:21-24.
50. Androdias G, Maillet D, Marignier R, et al. Mycophenolate mofetil may be effective in CNS sarcoidosis but not in sarcoid myopathy. Neurology. 2011;76(13):1168-1172.
51. Kouba DJ, Mimouni D, Rencic A, Nousari HC. Mycophenolate mofetil may serve as a steroid-sparing agent for sarcoidosis. Br J Dermatol. 2003;148(1):147-148.
52. Bhat P, Cervantes-Castaneda RA, Doctor PP, Anzaar F, Foster CS. Mycophenolate mofetil therapy for sarcoidosis-associated uveitis. Ocul Immunol Inflamm. 2009;17(3):185-190.
53. Doty JD, Mazur JE, Judson MA. Treatment of corticosteroid-resistant neurosarcoidosis with a short-course cyclophosphamide regimen. Chest. 2003;124(5):2023-2026.
54. Chapelon-Abric C, de Zuttere D, Duhaut P, et al. Cardiac sarcoidosis: a retrospective study of 41 cases. Medicine. 2004;83(6):315-334.
55. Demeter SL. Myocardial sarcoidosis unresponsive to steroids. Treatment with cyclophosphamide. Chest. 1988;94(1):202-203.
56. Sodhi M, Pearson K, White ES, Culver DA. Infliximab therapy rescues cyclophosphamide failure in severe central nervous system sarcoidosis. Respir Med. 2009;103(2):268-273.
57. Haubitz M, Schellong S, Gobel U, et al. Intravenous pulse administration of cyclophosphamide versus daily oral treatment in patients with antineutrophil cytoplasmic antibody-associated vasculitis and renal involvement: a prospective, randomized study. Arthritis Rheum. 1998;41(10):1835-1844.
58. Somers EC, Marder W, Christman GM, Ognenovski V, McCune WJ. Use of a gonadotropin-releasing hormone analog for protection against premature ovarian failure during cyclophosphamide therapy in women with severe lupus. Arthritis Rheum. 2005;52(9):2761-2767.
59. Judson MA, Silvestri J, Hartung C, Byars T, Cox CE. The effect of thalidomide on corticosteroid-dependent pulmonary sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2006;23(1):51-57.
60. Zabel P, Entzian P, Dalhoff K, Schlaak M. Pentoxifylline in treatment of sarcoidosis. Am J Respir Crit Care Med. 1997;155(5):1665-1669.
61. Doty JD, Mazur JE, Judson MA. Treatment of sarcoidosis with infliximab. Chest. 2005;127(3):1064-1071.
62. Baughman RP, Lower EE. Infliximab for refractory sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2001;18(1):70-74.
63. Fehrenbach H, Zissel G, Goldmann T, et al. Alveolar macrophages are the main source for tumour necrosis factor-alpha in patients with sarcoidosis. Eur Respir J. 2003;21(3):421-428.
64. Zissel G, Muller-Quernheim J. Sarcoidosis: historical perspective and immunopathogenesis (Part I). Respir Med. 1998;92(2):126-139.
65. Judson MA, Baughman RP, Costabel U, et al. Efficacy of infliximab in extrapulmonary sarcoidosis: results from a randomised trial. Eur Respir J. 2008;31(6):1189-1196.
66. Stagaki E, Mountford WK, Lackland DT, Judson MA. The treatment of lupus pernio: results of 116 treatment courses in 54 patients. Chest. 2009;135(2):468-476.
67. Panselinas E, Rodgers JK, Judson MA. Clinical outcomes in sarcoidosis after cessation of infliximab treatment. Respirology. 2009;14(4):522-528.
68. Keane J, Gershon S, Wise RP, et al. Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent. N Engl J Med. 2001;345(15):1098-1104.
69. Lopez-Olivo MA, Tayar JH, Martinez-Lopez JA, et al. Risk of malignancies in patients with rheumatoid arthritis treated with biologic therapy: a meta-analysis. JAMA. 2012;308(9):898-908.
70. Cush JJ, Dao KH. Malignancy risks with biologic therapies. Rheum Dis Clin North Am. 2012;38(4):761-770.
71. Nozaki K, Silver RM, Stickler DE, et al. Neurological deficits during treatment with tumor necrosis factor-alpha antagonists. Am J Med Sci. 2011;342(5):352-355.
72. Erckens RJ, Mostard RL, Wijnen PA, Schouten JS, Drent M. Adalimumab successful in sarcoidosis patients with refractory chronic non-infectious uveitis. Graefes Arch Clin Exp Ophthalmol. 2012;250(5):713-720.
73. Baughman RP, Lower EE, Bradley DA, Raymond LA, Kaufman A. Etanercept for refractory ocular sarcoidosis: results of a double-blind randomized trial. Chest. 2005;128(2):1062-1047.
74. Utz JP, Limper AH, Kalra S, et al. Etanercept for the treatment of stage II and III progressive pulmonary sarcoidosis. Chest. 2003;124(1):177-185.
75. Louie GH, Chitkara P, Ward MM. Relapse of sarcoidosis upon treatment with etanercept. Ann Rheum Dis. 2008;67(6):896-898.
76. van der Stoep D, Braunstahl GJ, van Zeben J, Wouters J. Sarcoidosis during anti-tumor necrosis factor-alpha therapy: no relapse after rechallenge. J Rheumatol. 2009;36(12):2847-2848.
77. Verschueren K, Van Essche E, Verschueren P, Taelman V, Westhovens R. Development of sarcoidosis in etanercept-treated rheumatoid arthritis patients. Clin Rheumatol. 2007;26(11):1969-1971.
78. Burns AM, Green PJ, Pasternak S. Etanercept-induced cutaneous and pulmonary sarcoid-like granulomas resolving with adalimumab. J Cutan Pathol. 2012;39(2):289-293.
79. Baughman RP, Judson MA, Teirstein AS, Moller DR, Lower EE. Thalidomide for chronic sarcoidosis. Chest. 2002;122(1):227-232.
80. Baughman RP, Judson MA, Ingledue R, Craft NL, Lower EE. Efficacy and safety of apremilast in chronic cutaneous sarcoidosis. Arch Dermatol. 2012;148(2):262-264.
81. Lower EE, Baughman RP, Kaufman AH. Rituximab for refractory granulomatous eye disease. Clin Ophthalmol. 2012;6:1613-1618.
82. Bomprezzi R, Pati S, Chansakul C, Vollmer T. A case of neurosarcoidosis successfully treated with rituximab. Neurology. 2010;75(6):568-570.
83. Bachelez H, Senet P, Cadranel J, Kaoukhov A, Dubertret L. The use of tetracyclines for the treatment of sarcoidosis. Arch Dermatol. 2001;137(1):69-73.
84. Wyser CP, van Schalkwyk EM, Alheit B, Bardin PG, Joubert JR. Treatment of progressive pulmonary sarcoidosis with cyclosporin A. A randomized controlled trial. Am J Respir Crit Care Med. 1997;156(5):1371-1376.
85. Stern BJ, Schonfeld SA, Sewell C, Krumholz A, Scott P, Belendiuk G. The treatment of neurosarcoidosis with cyclosporine. Arch Neurol. 1992;49(10):1065-1072.
86. Judson MA. The management of sarcoidosis by the primary care physician. Am J Med. 2007;120(5):403-407.
87. Petrache I, Moller DR. Mechanism of therapy for sarcoidosis. In: Baughman RP, editor. Sarcoidosis. New York, NY: Taylor and Francis Group; 2006;210:671-687.
88. Khalil N, Whitman C, Zuo L, Danielpour D, Greenberg A. Regulation of alveolar macrophage transforming growth factor-beta secretion by corticosteroids in bleomycin-induced pulmonary inflammation in the rat. J Clinical Invest. 1993;92(4):1812-1818.
89. Chen ES, Song Z, Willett MH, et al. Serum amyloid A regulates granulomatous inflammation in sarcoidosis through Toll-like receptor-2. Am J Respir Crit Care Med. 2010;181(4):360-373.