Durable remission of cardiac sarcoidosis following discontinuation of methotrexate: A prospective cohort study
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View abstract on PubMed
Summary
This summary is machine-generated.Most patients with cardiac sarcoidosis (CS) remained in remission after stopping Methotrexate (MTX). This suggests MTX may be safely discontinued in some CS patients, but larger studies are needed.
Area Of Science
- Cardiology
- Immunology
- Rheumatology
Background
- Cardiac sarcoidosis (CS) treatment presents challenges due to limited data on optimal therapies and duration.
- Previous research suggests three disease phenotypes in pulmonary sarcoidosis: acute, chronic, and advanced.
- A prior study indicated that one-third of CS patients did not relapse after a one-year corticosteroid course.
Purpose Of The Study
- To investigate relapse rates in cardiac sarcoidosis patients following the discontinuation of Methotrexate (MTX).
- To evaluate the safety and efficacy of MTX withdrawal in managing cardiac sarcoidosis.
Main Methods
- A single-centre sub-study of the CHASM-CS prospective cohort.
- PET scans were performed 6-12 months post-MTX discontinuation to assess for cardiac relapse.
- Patients without cardiac relapse were monitored clinically with annual ECGs and echocardiograms.
Main Results
- Twelve MTX responders (mean age 53.6 years, 66.6% female) were included.
- One patient (8.3%) experienced recurrent cardiac and extracardiac sarcoidosis, including ventricular tachycardia storm.
- Four patients (33.3%) had recurrent extracardiac sarcoidosis only; 11 remained in remission.
Conclusions
- A high remission rate (91.7%) was observed in CS patients after MTX discontinuation.
- These findings suggest potential for safe MTX withdrawal in select CS patients.
- Replication in larger patient populations is necessary to confirm these results.
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