Neurosarcoidosis occurs in about 5-15% of patients with sarcoidosis. Therapy with corticosteroids is generally accepted as the first-line medication, followed by various immunomodulating and cytotoxic agents or combined therapy. However, some patients show an unsatisfactory outcome or have adverse events and require novel treatment strategies.
We describe three patients with systemic sarcoidosis and central nervous system involvement who received CD20-targeted B-cell depletion with rituximab.
Treatment with rituximab was well tolerated and followed by marked remission in patients nonresponsive to other immunosuppressive agents.
Rituximab may be used for patients with neurosarcoidosis who are nonresponsive to established treatment regimes.