Thomas Barba1,2, Alicia Marquet1,2, Diane Bouvry3, Fleur Cohen-Aubart4, Marc Ruivard5, Sébastien Debarbieux6, Chahéra Khouatra7, Alain Vighetto8, Audrey de Parisot1, Dominique Valeyre3, Pascal Sève1,2. 1. Département de Médecine Interne, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France. 2. Université Claude Bernard, Lyon 1, Villeurbanne, France. 3. AP-HP, Département de Pneumologie, Hôpital Avicenne, and Université Paris 13, COMUE Sorbonne Paris Cité, Bobigny, France. 4. Département de Médecine Interne et d'Immunologie Clinique II, Assistance Publique-Hôpitaux de Paris (AP-HP), CHU Pitié Salpêtrière, Université Pierre et Marie Curie (UPMC), Paris, France. 5. Département de Médecine Interne, CHU Estaing, Clermont-Ferrand, France. 6. Département de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France. 7. Département de Pneumologie, Hospices Civils de Lyon, Bron, France. 8. Département de Neurologie, Hospices Civils de Lyon, Bron, France.
Abstract
Background: Upper respiratory tract (URT) involvement in sarcoidosis may be refractory to corticosteroids and immunosuppressants. Whether TNF-antagonists are efficient and safe in such phenotype is unknown. Methods: STAT is a French national drug registry including patients presenting sarcoidosis treated with TNF alpha antagonists. All cases of biopsy-proven sinonasal and laryngeal sarcoidosis were extracted and retrospectively analyzed from July 2014 to July 2015. Results: Twelve patients presenting biopsy-proven sarcoidosis with URT involvement were included in the STAT registry. Infliximab appeared effective in decreasing URT symptoms, as assessed by a significant decrease of the e-POST (extra-pulmonary Physician Organ Severity Tool) (1.5 [0-2] vs 5 [1.5-5], p=0.03) and a corticosteroids-sparing effect (7.5mg per day [5-10] vs 17.5 mg per day [7.5-20], p=0.04) at the end of follow-up. Conclusions: TNF-antagonists may be an efficient treatment of refractory URT manifestations and should be discussed when prolonged or high dosages of corticosteroids despite immunosuppressive therapy are required. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 343-351). Copyright:
Background: Upper respiratory tract (URT) involvement in sarcoidosis may be refractory to corticosteroids and immunosuppressants. Whether TNF-antagonists are efficient and safe in such phenotype is unknown. Methods: STAT is a French national drug registry including patients presenting sarcoidosis treated with TNF alpha antagonists. All cases of biopsy-proven sinonasal and laryngeal sarcoidosis were extracted and retrospectively analyzed from July 2014 to July 2015. Results: Twelve patients presenting biopsy-proven sarcoidosis with URT involvement were included in the STAT registry. Infliximab appeared effective in decreasing URT symptoms, as assessed by a significant decrease of the e-POST (extra-pulmonary Physician Organ Severity Tool) (1.5 [0-2] vs 5 [1.5-5], p=0.03) and a corticosteroids-sparing effect (7.5mg per day [5-10] vs 17.5 mg per day [7.5-20], p=0.04) at the end of follow-up. Conclusions: TNF-antagonists may be an efficient treatment of refractory URT manifestations and should be discussed when prolonged or high dosages of corticosteroids despite immunosuppressive therapy are required. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 343-351). Copyright:
Authors: Marc A Judson; Robert P Baughman; Ulrich Costabel; Marjolein Drent; Kevin F Gibson; Ganesh Raghu; Hidenobu Shigemitsu; Joseph B Barney; Daniel A Culver; Nabeel Y Hamzeh; Marlies S Wijsenbeek; Carlo Albera; Isham Huizar; Prasheen Agarwal; Carrie Brodmerkel; Rosemary Watt; Elliot S Barnathan Journal: Eur Respir J Date: 2014-07-17 Impact factor: 16.671
Authors: Bayan O Besharah; Revan A Mujahed; Haddad H AlKaf; Sherif K Abdelmonim; Ali Aboloyoun Mohamed; Hasheema Alsulami; Mohammad A Al-Essa Journal: Ann Med Surg (Lond) Date: 2022-07-31