The following is a summary of “Durable medication-free remission of sarcoidosis following discontinuation of anti-tumor necrosis factor-α therapy,” published in the January 2023 issue of Pulmonology by Yee, et al.
The most effective time frame for using monoclonal antibodies against tumor necrosis factor-alpha (TNF-α) in the treatment of sarcoidosis remained unknown. According to published research, stopping treatment usually caused a quick return of the condition. For a study, researchers sought to identify and describe sarcoidosis patients who had and maintained medication-free illness remissions after receiving anti-TNF-α antibodies and then stopping those treatments.
A retrospective review of patient records was done to find those who met all three requirements: histopathological confirmation of sarcoidosis; disease remission brought on by anti-TNF-α antibodies since discontinued; and sustained clinical, radiological, and laboratory remission for at least one year without ongoing immunomodulatory medications.
There were 8 individuals with sarcoidosis who continued to experience drug-free remissions. Remissions lasted somewhere between 22 and 132 months. Anti-TNF-α antibodies were used on all patients because they had previously failed to respond adequately to corticosteroid treatment and at least one steroid-sparing medication. All 8 patients had been able to avoid systemic corticosteroid medication for at least a year before anti-TNF-α therapy was stopped (range 12–130 months).
The findings implied that anti-TNF-α antibodies might cause extended drug-free remissions in a subset of sarcoidosis patients. During anti-TNF-α therapy, the ability to successfully avoid using corticosteroids may be a promising prognostic sign for ongoing disease remission. The results may contribute to the formulation of guidelines for the best application of these medications and provide insight into the potential pathogenic involvement of TNF-α in the disease.
Reference: resmedjournal.com/article/S0954-6111(22)00320-1/fulltext