Sarcoidosis

Risk Indicators of Sarcoidosis Evolution-Unified Protocol (RISE-UP)

Status: Recruiting

Location: University of Maryland, University of Texas Southwestern

Conditions: University of Maryland, University of Texas Southwestern

City/State:

Baltimore, Maryland

Dallas, Texas

Contact Information:

Laura Koth
4155144369
[email protected]

Jessica Cardenas
[email protected]

Brief Summary:
The purpose of this study is to develop prediction models that can prognosticate patients with sarcoidosis using clinical data and blood markers that can be obtained during a clinic visit.
Detailed Description:

The purpose of this study is to develop prediction models that can prognosticate patients with sarcoidosis using clinical data and biological markers that can be obtained during a clinic visit.

Primary Aim/Objective The primary objective of this study is to determine which clinical features measured during a routine clinic visit are risk factors for progression of pulmonary sarcoidosis over the follow-up period in adults with pulmonary sarcoidosis.

Secondary Aim/Objectives The secondary objective is to determine if blood biomarkers measured during a routine clinic visit can improve the risk assessment for progression of pulmonary sarcoidosis over the follow-up period.

The investigators will measure two types of blood markers to achieve this goal:

      • Clinically available blood markers that are available in most clinical labs
      • Blood proteins and gene expression that reflect interferon inflammation and are not currently available as tests in clinical labs

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Use of CXCL9 as a Biomarker of Acthar Efficacy (Acthar)

Status: Recruiting

Location: University of California- San Francisco

Conditions: University of California- San Francisco

City/State:

San Fransisco, California

Contact Information:

Laura Koth, MD
(415) 514-4369
[email protected]

Brief Summary:
The objective is this study is to test whether use of Acthar gel in the context of sarcoidosis will lead to improved symptoms and lung function and correlate with decreased levels of predictive blood biomarkers, like chemokine ligand 9 (CXCL9).
Detailed Description:
The investigators will test whether Acthar gel’s anti-inflammatory properties will modulate immune cells and lead to decreases in blood biomarkers and improvements in clinical parameters. Specific Aim 1 will examine the levels of the predictive biomarker, chemokine ligand 9 (CXCL9), and related transcripts, and determine whether they decrease in participants over time while taking Acthar. Specific Aim 2 will test whether the biologic changes measured in blood correlate to clinical markers, including lung function and symptom scores. Since the investigators have found that CXCL9 predicts clinical course, they hypothesize that CXCL9 transcript levels in the blood will decrease over time in pulmonary sarcoidosis participants whose clinical outcome measures improve with Acthar.
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Delayed-Enhancement Cardiovascular Magnetic Resonance in Patients With Sarcoidosis

Status: Recruiting

Location: Duke University Medical Center

Conditions: Duke University Medical Center

City/State:

Durham, North Carolina

Contact Information:

Han W Kim, MD
919-668-3539
[email protected]

Raymond J. Kim, MD
919-668-3539
[email protected]

Brief Summary:
The primary objective of this study was to determine the ability of cardiac magnetic resonance (CMR) to identify cardiac involvement in patients with sarcoidosis. Patients were to undergo CMR in addition to routine clinical evaluation.
Detailed Description:
In patients with sarcoidosis, cardiac death is a leading cause of mortality which may represent unrecognized cardiac involvement. Cardiovascular magnetic resonance (CMR) can detect cardiac involvement including minute amounts of myocardial damage. Therefore, the objective of this study was to determine the usefulness of CMR and compare it with standard clinical evaluation for cardiac involvement. Patients with documented extracardiac sarcoidosis or clinically suspected cardiac sarcoidosis will be enrolled.
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Epigenetic Regulation of Altered T-cell Immunity in Sarcoidosis

Status: Recruiting

Location: University of California- San Francisco

Conditions: University of California- San Francisco

City/State:

San Fransisco, California

Contact Information:

Victoria Wang, BS
415 476 9225
[email protected]

Brief Summary:
Sarcoidosis is a multi-system granulomatous disorder that is triggered and influenced by gene-environment interactions. Although sarcoidosis predominantly affects the lungs in most cases, the clinical disease course is highly variable and any organ can be affected leading to end organ damage despite currently available therapeutics that unfortunately also have numerous and potentially devastating side effects. The environmental triggers of sarcoidosis are unknown but several occupational, environmental and infectious agents have been associated with sarcoidosis in susceptible hosts. Exposure to these triggers result in inflammation, characterized by activation of CD4+ T-cells, cytokine production, subsequent recruitment of other immune cells, and granuloma formation. Although several genetic markers have been associated with sarcoidosis, none fully explain individual susceptibility or clinical course variability, strongly implicating the environment and epigenetics. We have the ability to generate a map of the epigenetic histone modifications in immune cells via Chromatin Immuno-Precipitation coupled with next generation sequencing (ChIP-seq) and a map of transcriptome profiles via RNA-seq. The availability of histone and transcriptional signatures defining T cell activity in sarcoidosis will help identify the specific molecular programs affected by disease processes and can become the basis for future discovery of novel biomarker diagnostics in a clinical setting.
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Cardiac Sarcoidosis Randomized Trial

Status: Recruiting

Location: Allegheny General Hospital, Montefiore Medical Center, Ohio State University Medical Center, Tufts Medical Center, University of Michigan, University of Minnesota, University of Utah, Virginia Commonwealth University, Yale-New Haven Hospital

Conditions: Allegheny General Hospital, Montefiore Medical Center, Ohio State University Medical Center, Tufts Medical Center, University of Michigan, University of Minnesota, University of Utah, Virginia Commonwealth University, Yale-New Haven Hospital

City/State:

New Haven, Connecticut

Boston, Massachusetts

Ann Arbor, Michigan

New York, New York

Columbus, Ohio

Pittsburgh, Pennsylvania

Salt Lake City, Utah

Richmond, Virginia

Contact Information:

David H Birnie, MD
613-696-7269
[email protected]

Janine Ryan, BAH, CCRP
613-696-7000 ext 17077
[email protected]

Brief Summary:

Prospective randomized controlled trial comparing low dose Prednisone(or Prednisolone)/Methotrexate combination to standard dose Prednisone(or Prednisolone) in patients diagnosed with acute active clinically manifest cardiac sarcoidosis and not yet treated.

The Investigators hypothesize that low dose Prednisone(or Prednisolone)/Methotrexate combination will be as effective as standard dose Prednisone(or Prednisolone), and result in significantly better quality of life and less toxicity than standard dose Prednisone(or Prednisolone).

Detailed Description:

Subjects meeting the study inclusion/exclusion criteria will be randomized equally to receive either:

Everywhere but Japan:

      1. Prednisone 0.5 mg kg/day for 6-months (MAX dose 30 mg per day) or
      2. Methotrexate 15-20 mg po, sc, or IM once a week for 6-months + Folic Acid 2 mg OD for 6 months + Prednisone 20 mg day for 1 month, then 10 mg OD for 1 month, then 5 mg OD for one month then STOP
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