{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:16:38Z","timestamp":1791958598896,"version":"4.3.4"},"reference-count":64,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,9,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Long\u2010term corticosteroid therapy is the standard of care for treatment of cardiac sarcoidosis (\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              ). The efficacy of long\u2010term corticosteroid\u2010sparing immunosuppression in\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              is unknown. The goal of this study was to assess the efficacy of methotrexate with or without adalimumab for long\u2010term disease suppression in\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              , and to assess recurrence and adverse event rates after immunosuppression discontinuation.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Retrospective chart review identified treatment\u2010naive\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              patients at a single academic medical center who received corticosteroid\u2010sparing maintenance therapy. Demographics, cardiac uptake of 18\u2010fluorodeoxyglucose, and adverse cardiac events were compared before and during treatment and between those with persistent or interrupted immunosuppression. Twenty\u2010eight\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              patients were followed for a mean 4.1 (\n              <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n              1.5) years. Twenty\u2010five patients received 4 to 8\u00a0weeks of high\u2010dose prednisone (&gt;30\u00a0mg\/day), followed by taper and maintenance therapy with methotrexate\u00b1low\u2010dose prednisone (low\u2010dose prednisone, &lt;10\u00a0mg\/day). Adalimumab was added in 19 patients with persistently active\n              <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n              or in those with intolerance to methotrexate. Methotrexate\u00b1low\u2010dose prednisone resulted in initial reduction (88%) or elimination (60%) of 18\u2010fluorodeoxyglucose uptake, and patients receiving adalimumab\u2010containing regimens experienced improved (84%) or resolved (63%) 18\u2010fluorodeoxyglucose uptake. Radiologic relapse occurred in 8 of 9 patients after immunosuppression cessation, 4 patients on methotrexate\u2010containing regimens, and in no patients on adalimumab\u2010containing regimens.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Corticosteroid\u2010sparing regimens containing methotrexate with or without adalimumab is an effective maintenance therapy in patients after an initial response is confirmed. Disease recurrence in patients on and off immunosuppression support need for ongoing radiologic surveillance regardless of immunosuppression regimen.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.010952","type":"journal-article","created":{"date-parts":[[2019,9,6]],"date-time":"2019-09-06T09:00:20Z","timestamp":1567760420000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":94,"title":["Long\u2010Term Corticosteroid\u2010Sparing Immunosuppression for Cardiac Sarcoidosis"],"prefix":"10.1161","volume":"8","author":[{"given":"David G.","family":"Rosenthal","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Medicine University of California, San Francisco San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Purvi","family":"Parwani","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine University of California, San 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