Students' Scientific Group of Rheumatology and Immunology, Jagiellonian University Medical College, Krakow, 30-688, Poland.
Department of Rheumatology and Immunology, Jagiellonian University Medical College, ul. Jakubowskiego 2, Krakow, 30-688, Poland.
Rheumatol Int. 2024 Oct;44(10):2239-2244. doi: 10.1007/s00296-024-05680-8. Epub 2024 Aug 24.
Tumour necrosis factor-α (TNF- α) antagonists are considered a significant therapeutic option in the treatment of sarcoidosis. Nevertheless, their use can also paradoxically result in sarcoidosis-like reactions. Here, we present a case of a 56-year-old patient with psoriatic arthritis who after 3 months of certolizumab therapy developed pulmonary sarcoidosis. Therefore, certolizumab was discontinued and prednisone initiated. Subsequently, 4 months later a complete remission of interstitial lesions was observed. Due to insufficient control of psoriatic arthritis, upadacitinib and methotrexate were prescribed and despite initial improvement, a couple of months later a massive exacerbation of skin psoriasis occurred and the treatment was switched to secukinumab. As of today, no evidence of sarcoidosis recurrence has been noted. Drug-induced sarcoidosis-like reactions (DISR) appear to be less frequently associated with certolizumab rather than with other anti-TNF-α agents. However, specific mechanisms of this phenomenon remain unclear and require future investigation.
肿瘤坏死因子-α（TNF-α）拮抗剂被认为是治疗类肉瘤病的重要治疗选择。然而，它们的使用也可能会产生类肉瘤病样反应。在这里，我们介绍了一例 56 岁患有银屑病关节炎的患者，他在使用certolizumab 治疗 3 个月后出现了肺类肉瘤病。因此，停用了 certolizumab 并开始使用泼尼松龙。随后，4 个月后观察到间质性病变完全缓解。由于银屑病关节炎控制不佳，给予了 upadacitinib 和甲氨蝶呤治疗，尽管最初有所改善，但几个月后皮肤银屑病出现了严重恶化，治疗药物更换为 secukinumab。截至目前，未发现类肉瘤病复发的证据。与其他抗 TNF-α 药物相比，药物引起的类肉瘤病样反应（DISR）似乎与 certolizumab 的相关性较低。然而，这种现象的具体机制尚不清楚，需要进一步研究。
