Anti-TNF-alpha therapy in the management of severe neurosarcoidosis: a report of five cases from a single centre and literature review

作者：Riancho Zarrabeitia L; Delgado Alvarado M; Riancho J; Oterino A; Sedano M J; Rueda Gotor J; Perez Martin I; Gonzalez Vela M C; Berciano J; Gonzalez Gay M A^*; Blanco R

来源：Clinical and Experimental Rheumatology, 2014, 32(2): 275-284.

• neurosarcoidosis
• central nervous system
• anti-TNF-alpha therapy

Neurologic manifestations are found in 5-15 % of patients with sarcoidosis. This granulomatous disease may affect any part of the peripheral or the central nervous system, being potentially severe and difficult to treat. Corticosteroids are the cornerstone of therapy in sarcoidosis. However, some patients become resistant or experience side effects to corticosteroids. In these patients, second line therapies including immunosuppressive drugs such as methotrexate, azathioprine, mycophenolate, cyclophosphanzide and letlunomide have been used. Anti-TNF-alpha drugs have been proposed as a therapeutic option for those who are refractory to immunosuppressive drugs or initially in cases of severe sarcoidosis. We report on 5 patients with neurosarcoidosis treated with anti-TNF-alpha drugs in our center. A literature review of patients with neurosarcoidosis treated with anti-TNF-alpha drugs was conducted. In our series successful response to anti-TNF-alpha therapy was achieved. However, the high frequency of relapses following anti-TNF-alpha discontinuation makes necessary a close follow-up of these patients when the biologic agent is stopped.

• 出版日期2014-4