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Article in English | MEDLINE | ID: mdl-32404428

ABSTRACT

OBJECTIVE: To characterize patients with neurosarcoidosis within the University of Utah healthcare system, including demographics, clinical characteristics, treatment, and long-term outcomes. METHODS: We describe the clinical features and outcomes of patients with neurosarcoidosis within the University of Utah healthcare system (a large referral center for 10% of the continental United States by land mass). Patients were selected who met the following criteria: (1) at least one International Classification of Diseases Clinical Modification, 9th revision code 135 or International Classification of Diseases Clinical Modification, 10th revision code D86* (sarcoidosis) and (2) at least one outpatient visit with a University of Utah clinician in the Neurology Department within the University of Utah electronic health record. RESULTS: We identified 56 patients meeting the study criteria. Thirty-five patients (63%) were women, and most patients (84%) were white. Twelve patients (22%) met the criteria for definite neurosarcoidosis, 36 patients (64%) were diagnosed with probable neurosarcoidosis, and 8 patients (14%) were diagnosed with possible neurosarcoidosis. A total of 8 medications were used for the treatment of neurosarcoidosis. Prednisone was the first-line treatment in 51 patients (91%). Infliximab was the most effective therapy, with 87% of patients remaining stable or improving on infliximab. Treatment response for methotrexate and azathioprine was mixed, and mycophenolate mofetil and rituximab were the least effective treatments in this cohort. CONCLUSIONS: This is a comprehensive characterization of neurosarcoidosis within a single healthcare system at the University of Utah that reports long-term response to treatment and outcomes of patients with neurosarcoidosis. Our results suggest the use of infliximab as a first-line therapy for neurosarcoidosis.


Subject(s)
Antirheumatic Agents/therapeutic use , Central Nervous System Diseases/drug therapy , Central Nervous System Diseases/epidemiology , Glucocorticoids/therapeutic use , Immunologic Factors/therapeutic use , Infliximab/therapeutic use , Sarcoidosis/drug therapy , Sarcoidosis/epidemiology , Academic Medical Centers/statistics & numerical data , Adult , Central Nervous System Diseases/diagnosis , Central Nervous System Diseases/ethnology , Female , Health Services/statistics & numerical data , Humans , Longitudinal Studies , Male , Middle Aged , Sarcoidosis/diagnosis , Sarcoidosis/ethnology , Utah/epidemiology
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