Abstract Details

Title Rise of the Biologics: Shifting Prescribing Patterns for Neurosarcoidosis

Topic Autoimmune Neurology

Presentation(s) P9 - Poster Session 9 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-001

Objective To evaluate whether there has been increased use of biologic medications including infliximab, adalimumab, and tocilizumab for the treatment of neurosarcoidosis at our center.

Background Sarcoidosis is a granulomatous inflammatory disease of unknown etiology that rarely affects the nervous system as neurosarcoidosis. In recent years, there has been increasing evidence for the use of biologics, including infliximab, adalimumab, and tocilizumab for the maintenance treatment of neurosarcoidosis. Here, we evaluate whether prescribing patterns at our center have shifted toward the use of these drugs or whether most patients remain on more traditional therapies.

Design/Methods Using SlicerDicer (Epic) patients were identified who had an encounter at our center in the past 8 years and carried a diagnosis of “neurosarcoidosis” or “sarcoid meningitis.” From that population, a search was done to see whether patients were on steroid-sparing maintenance medications for treatment of neurosarcoidosis including mycophenolate, methotrexate, azathioprine, cyclophosphamide, cyclosporine, infliximab, adalimumab, or tocilizumab.

Results The number of patients being treated with steroid-sparing agents for neurosarcoidosis has increased over the past 8 years from 18 to 116. For those patients, biologic prescribing has gradually increased (12.5% to 31.9%). This change was largely driven by increased use of infliximab (5.6% to 23.3%) and declining use of mycophenolate (27.8% to 24%). No patients were on tocilizumab while adalimumab prescribing has slightly increased (5.6% to 8.6%).

Conclusions This study shows a recent shift toward the use of biologics, particularly infliximab and adalimumab, for the steroid-sparing maintenance treatment of neurosarcoidosis. This change in prescribing patterns likely reflects improved availability of biologic medications and increasing evidence for their use for treating neurosarcoidosis.

Authors/Disclosures
Elijah Lackey, MD PRESENTER	Dr. Lackey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Lackey has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Lackey has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Doximity.
Kristen L. Veal (Duke Hospital)	Dr. Veal has nothing to disclose.
Suma Shah, MD (Duke University Medical Center)	Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Shah has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. The institution of Dr. Shah has received research support from Biogen. The institution of Dr. Shah has received research support from National MS Society.
Christopher P. Eckstein, MD	The institution of Dr. Eckstein has received research support from Biogen. The institution of Dr. Eckstein has received research support from Genzyme.

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