Efficacy and safety of TNF antagonists in sarcoidosis: data from the Spanish registry of biologics BIOBADASER and a systematic review
Open accessAbstract
Objective To evaluate the safety, efficacy, and effectiveness of TNF antagonists in patients with sarcoidosis.Methods A descriptive study of a case series registered in BIOBADASER and a systematic review was performed. The search strategy of articles published between 1998 and July 2011 in Medline, Embase, and the Cochrane Library included synonyms of sarcoidosis and synonyms of TNF antagonists.Results Seven patients treated with infliximab (IFX) and 1 with etanercept (ETN) switched to IFX for inefficacy were registered in BIOBADASER 2.0. In 3, treatment is still ongoing. Reasons for discontinuation were serious adverse events in 2 cases, inefficacy in 2 cases, and complete clinical response in 2 cases. Eight serious adverse events were reported. In the selected 69 of 2262 reports and 1 abstract of the review, 232 patients (89.9%) were treated with IFX and 26 (10.0%) were treated with ETN. In 2 randomized clinical trials, favorable response of the lung disease was reported with IFX. In other randomized clinical trials, no improvement of ocular manifestations was reported with ETN. In the cases series, results were diverse. Mean weighted rates of adverse events, infections, serious infections, and malignancy were 39.9, 22.1, 5.9, and 1.0 per 100 patient-years, respectively.Conclusions There is insufficient evidence to ensure the efficacy of TNF antagonists in sarcoidosis. Nevertheless, IFX may be effective in selected manifestations of the disease. Before starting treatment of sarcoidosis with IFX, a careful evaluation of the benefit/risk ratio must be considered on an individual basis.
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TNF antagonists allow corticosteroid tapering and are highly efficacious in patients with severe/refractory sarcoidosis, with success rates in skin (80%), neurologic (95%), hepatic (50%), cardiac (88%), bone (67%), and ocular sarcoidosis (86%).
“TNF antagonists allow CS tapering and are highly efficacious in patients with severe/refractory SX with success rates in skin (80%), neurologic (95%), hepatic (50%), cardiac (88%), bone (67%), and ocular SX (86%).103,104”
From Autoimmune diseases and immune-checkpoint inhibitors for cancer therapy: Review of the literature and personalized risk-based prevention strategy (2020) · cites this paper as [104]
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- Authors
- Maneiro, J. R., Salgado, E., Gomez-Reino, J. J., & Carmona, L.
- Affiliations
- Complejo Hospitalario Universitario de Santiago (ES)
- ORCID
- Carmona, Loreto
- Venue
- Seminars in Arthritis and Rheumatism
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 42
- Issue
- 1
- Pages
- 89-103
- ISSN
- 0049-0172 (ISSN-L)
- OpenAlex
- W1979164636
- Cited by
- 59
- References
- 84
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 5 · 2019: 5 · 2018: 6 · 2017: 4 · 2016: 4 · 2015: 7 · 2014: 7 · 2013: 9 · 2012: 3
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Seminars in Arthritis and Rheumatism (publishedVersion)
- PubMed (publishedVersion)
- RUNA. Repositorio Institucional del Sergas (Servicio Gallego de Salud (SERGAS)) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Physiology › Sarcoidosis and Beryllium Toxicity Research
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Keywords
- sarcoidosis, TNF antagonists, infliximab, etanercept, adverse events, serious infections, cancer, treatment efficacy, ocular sarcoidosis, pulmonary sarcoidosis, risk-benefit assessment
- MeSH terms
- Etanercept, Infliximab, Adult, Antibodies, Monoclonal, Female, Humans, Immunoglobulin G, Male, Middle Aged, Registries, Sarcoidosis, Spain, Tumor Necrosis Factor-alpha, Receptors, Tumor Necrosis Factor, Antirheumatic Agents, Young Adult, Drug Substitution, Pharmacovigilance, Time-to-Treatment
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