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Narrative review of adalimumab for the treatment of cardiac sarcoidosis

Published inHeart rhythm O2
First online date2025-01-09
Abstract

Cardiac sarcoidosis (CS) remains the second leading cause of death in patients with sarcoidosis, primarily because of its association with heart failure and arrhythmias. While corticosteroids are first-line therapy, their long-term use in CS is associated with serious adverse events, necessitating alternative immunosuppressive therapies, such as tumor necrosis factor inhibitors. Although infliximab is the most studied tumor necrosis factor inhibitor for refractory CS, adalimumab has emerged as a potential alternative. To that end, we reviewed the literature on adalimumab treatment in CS, identifying 12 publications published between January 2000 and September 2024 encompassing 240 patients, of whom 100 (42%) received adalimumab and were followed for at least 6 months. Most patients demonstrated stable or improved left ventricular ejection fraction, even those with initially low left ventricular ejection fraction and reduced cardiac 18F-fluorodeoxyglucose uptake on positron emission tomography–computed tomography. Adalimumab was generally well-tolerated with few reported infections or adverse events. However, these findings are limited by significant heterogeneity in study design, variability in patient populations, and a lack of standardized outcome measures, which restrict their generalizability. While adalimumab shows promise as a therapeutic option for refractory CS, robust, multicenter, randomized controlled trials are needed to validate these findings and define adalimumab’s role in clinical practice.

Keywords
  • Adalimumab
  • Arrhythmias
  • Cardiac sarcoidosis
  • Fully human monoclonal antibody
  • Granulomatous inflammation
  • Heart failure
  • Tumor necrosis factor
Citation (ISO format)
DOMINATI, Arnaud et al. Narrative review of adalimumab for the treatment of cardiac sarcoidosis. In: Heart rhythm O2, 2025. doi: 10.1016/j.hroo.2024.12.012
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Journal ISSN2666-5018
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Technical informations

Creation06/02/2025 15:25:44
First validation06/03/2025 13:46:47
Update13/10/2025 12:02:10
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