Which medications in the drug class Immunosuppressants are used in the treatment of Neurosarcoidosis?

Updated: Nov 13, 2018
  • Author: Gabriel Bucurescu, MD, MS; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Answer

Immunosuppressants

These agents inhibit immune cell growth and proliferation, decreasing immune system activity.

Thalidomide (Thalomid)

Thalidomide is an immunomodulatory agent that acts to inhibit production of TNF-α, which is an important mediator of central nervous system inflammation. Thalidomide enhances TNF- α messenger RNA degradation. It inhibits the upregulation of interleukin-6 and downregulates nuclear factor-κβ activity. Both of these molecules are elevated during the CNS inflammatory process in neurosarcoidosis.

Cyclophosphamide

Cyclophosphamide is an antimitotic agent mainly used as steroid-sparing therapy.

Cyclosporine (Sandimmune, Neoral, Gengraf)

Cyclosporine is used extensively in patients who have undergone transplantation. In neurosarcoidosis, beneficial effects of cyclosporine as an adjunct to steroids have been reported, although mostly in CNS rather than peripheral nervous system involvement.

Azathioprine (Imuran, Azasan)

Cytostatic drug that has been used in numerous immune-mediated diseases. Active component, 6-mercaptopurine, thought to have immune-suppressing properties.

Methotrexate (Trexall, Rheumatrex)

Methotrexate is an antimetabolite used as an immunosuppressant, often in rheumatoid arthritis, severe psoriasis, and certain neoplastic diseases. Its use for neurosarcoidosis has not been tested sufficiently.


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