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Abstract Details

Relapses in Neurosarcoidosis: Analysis of Disease Recurrence from a Single Center Cohort
Autoimmune Neurology
P8 - Poster Session 8 (5:30 PM-6:30 PM)
14-002

Neurosarcoidosis is notable for variable clinical manifestations and outcomes, as well as lack of FDA-approved treatments or high-quality prospective trials to guide treatment. We do not have evidence-based guidelines for immunotherapy selection or treatment duration.  

 

To analyze disease relapses within a well-characterized neurosarcoidosis cohort, with particular attention to length of illness, other organ system involvement, treatment strategy and duration, lesion location, and outcomes in patients with neurosarcoidosis within the University of Utah Healthcare System
Inclusion criteria for our cohort included: (i) At least one ICD-9-CM 135 or ICD-10-CM D86 (sarcoidosis) and (ii) At least 3 outpatient visits with a University of Utah clinician in the Neurology Department within the University of Utah electronic health record between July 1, 2010, through September 30, 2023. Neurosarcoidosis diagnoses were confirmed via a neuroimmunologist review of individual patient charts. 

78 patients met criteria for inclusion in the cohort. The average age of the cohort was 57 years, with 62% female. We analyzed: (i) Presenting neurologic and systemic symptoms (ii) Serial imaging and disease activity in relation to treatment, with corresponding clinical features and other organ involvement (iii) Relapse rate and timing with a special emphasis on duration and dose of corticosteroids (iv) Maintenance therapy and eventual functional outcomes. 

 

Relapses in neurosarcoidosis are challenging to predict, and the prevention of relapse must be balanced with risk of prolonged immunosuppression and individual patient comorbidities. Data is lacking regarding optimal immunotherapy selection, as well as the timing of de-escalation or cessation of immunotherapy once stability is attained in neurosarcoidosis patients.   
Authors/Disclosures
Aditi Sharma, MBBS (University of Utah)
PRESENTER
Dr. Sharma has nothing to disclose.
Ka-Ho Wong (U of U Neurology Clinic) The institution of Mr. Wong has received research support from The Sumaira Foundation .
Tammy L. Smith, MD, PhD (Imaging and Neurosciences Center) The institution of Dr. Smith has received research support from Alexion/AstraZeneca. Dr. Smith has a non-compensated relationship as a participant with Euroimmun Academy, receiving travel support to attend, that is relevant to AAN interests or activities.
Melissa A. Wright, MD (University of Utah) Dr. Wright has nothing to disclose.
Jennifer Lord, MD (Novant Health) Dr. Lord has nothing to disclose.
M. M. Paz Soldan, MD, PhD (University of Utah) Dr. Paz Soldan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Paz Soldan has received research support from National Institutes of Health. The institution of Dr. Paz Soldan has received research support from National Multiple Sclerosis Society. The institution of Dr. Paz Soldan has received research support from Western Institute for Biomedical Research. The institution of Dr. Paz Soldan has received research support from Biogen. The institution of Dr. Paz Soldan has received research support from Novartis. The institution of Dr. Paz Soldan has received research support from Clene Nanomedicine.
Robert Kadish, MD Dr. Kadish has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. The institution of Dr. Kadish has received research support from Alexion Pharmaceuticals.
Jonathan R. Galli, MD (University of Utah) Dr. Galli has nothing to disclose.
John W. Rose, MD, FAAN (Imaging and Neurosciences Center) The institution of Dr. Rose has received research support from National Multiple Sclerosis Society. The institution of Dr. Rose has received research support from Guthy Jackson Charitable Foundation. The institution of Dr. Rose has received research support from NIH . The institution of Dr. Rose has received research support from VA. The institution of Dr. Rose has received research support from Biogen. The institution of Dr. Rose has received research support from Friends of MS. Dr. Rose has received intellectual property interests from a discovery or technology relating to health care.
Stacey Clardy, MD, PhD, FAAN (University of Utah) Dr. Clardy has received personal compensation for serving as an employee of Veterans Health Administration (VHA). Dr. Clardy has received personal compensation for serving as an employee of University of Utah Health. Dr. Clardy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca/Alexion. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen/Horizon. Dr. Clardy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology/AAN Publications. The institution of Dr. Clardy has received research support from Sumaira Foundation for NMO. The institution of Dr. Clardy has received research support from NIH/NINDS. The institution of Dr. Clardy has received research support from SRNA. The institution of Dr. Clardy has received research support from Alexion/AstraZeneca. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a AAN Summer Meeting CoDirector Travel and Lodging with AAN. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Grand Rounds Travel/Lodging/Honoraria with U of Iowa, Miami, Stanford, Barrow, Beaumont Health, CCF, Emory.