Table 4.

Other drugs which are or can be used in the management of sarcoidosis

Drug	Main activity	Outcome	References
Abatacept	Anti-CTLA-4	Under investigation for sarcoidosis	[48]
Anakinra	IL-1 receptor antagonist	Under investigation for cardiac sarcoidosis	NCT04017936
Apremilast	Phosphodiesterase-4 inhibitor blocking TNF-α release from macrophages	Encouraging results in skin sarcoidosis	[49]
Atorvastatin	Inhibition of IFN-γ production by T lymphocytes	No GC-sparing effect in lung sarcoidosis, but reduction of mild-to-moderate flares	[50]
Canakinumab	Anti-IL-1β, interfering with innate immunity	Under investigation for lung sarcoidosis	NCT02888080
Cyclosporine	Calcineurin antagonist, inhibiting T-lymphocyte function	No advantage	[51, 52]
Daclizumab	Blocking CD25, part of the IL-2 receptor	Encouraging results but reports (although rare) of cancer	[53]
Etanercept	Anti-TNF	No benefits for pulmonary and eye sarcoidosis	[54, 55]
Golimumab	Anti-TNF	No advantage	[56]
Lenalidomide	Inhibition of NF-κB, a major inflammatory signalling family	Better tolerated than thalidomide	[57]
Maraviroc	Inhibitor of the chemokine CCR5-r	Under investigation	NCT0213471
Mesenchymal stromal cells	Inhibition of T lymphocytes by decreasing IFN-γ activity	GC-sparing effect in patients with advanced lung sarcoidosis, but with increase in mean pulmonary artery pressure	[58]
Transdermal nicotine	Attenuation of M1 polarization and NF-κB activation; activation of Tregs	Promising results	[59]
Pentoxifylline	Phosphodiesterase-4 inhibitor blocking TNF-α release from macrophages	Promising results in lung sarcoidosis but common gastrointestinal intolerance	[60]
Roflumilast	Phosphodiesterase-4 Inhibitor blocking TNF-α release from macrophages	Promising reduction of flares in chronic fibrotic lung sarcoidosis	[61]
Thalidomide	Inhibition of NF-κB, a major inflammatory signalling family	Contrasting results in patients with refractory lung and skin sarcoidosis but common side effects	[62–64]
Tocilizumab, sarilumab	Anti-IL-6r antibody, involved in differentiation of Th17 and Th17.1 cells	Improvement in case series	[65]
Tofacitinib, ruxolitinib	Inhibitor of Janus kinase, a major inflammatory signalling family	Improvement in case series, especially for skin sarcoidosis	[66–69]
Ustekinumab	Blocker of the minor subunit of IL-12, involved in differentiation of naïve T cells into Th1 cells	No advantage	[56]
Vasoactive intestinal peptide	Improvement of Treg function	Promising results	[70]