From the Research
There are no documented cases of sarcoidosis being treated with anifrolumab, and its use in this context would be considered experimental and off-label without supporting clinical evidence for safety or efficacy. As of my last update, anifrolumab (brand name Saphnelo) is a monoclonal antibody that targets the type I interferon receptor and is currently FDA-approved specifically for moderate to severe systemic lupus erythematosus (SLE) 1. While sarcoidosis is an inflammatory disorder characterized by granuloma formation and shares some immunological features with other autoimmune conditions, the standard treatments typically include:
- Corticosteroids like prednisone
- Steroid-sparing agents such as methotrexate, azathioprine, or mycophenolate mofetil
- TNF-alpha inhibitors like infliximab for refractory cases, as supported by studies on the use of adalimumab in sarcoidosis patients who developed intolerance to infliximab 2 The pathophysiology of sarcoidosis involves dysregulated T-cell responses and cytokine production, particularly TNF-alpha, which differs from the type I interferon pathway that anifrolumab targets. Current pharmacotherapy options and future directions for sarcoidosis treatment have been discussed in recent reviews, highlighting the need for new effective therapies to reduce or replace long-term therapy with glucocorticoids in patients with sarcoidosis 3. However, these reviews do not mention the use of anifrolumab in sarcoidosis treatment. Given the lack of evidence supporting the use of anifrolumab in sarcoidosis, the most appropriate course of action would be to stick with established treatments that have shown efficacy and safety in this patient population. In cases where patients are intolerant to infliximab, adalimumab has been shown to be an effective alternative, achieving clinical improvement in 39% and stabilization in 33% of patients 2. Additionally, adalimumab has been used in the treatment of neurosarcoidosis, with positive responses clinically and radiographically in a case series of ten patients 1. Overall, while anifrolumab may have potential in treating autoimmune conditions, its use in sarcoidosis is not supported by current evidence, and established treatments should be prioritized to ensure the best possible outcomes for patients in terms of morbidity, mortality, and quality of life.