How would you manage cardiac sarcoid with intolerance/contraindications to methotrexate, azathioprine, and mycophenolate/mycophenolic acid and that has proven refractory to adalimumab and infliximab as determined by PET?

I think it would be important to know the doses of the medications 'failed'.

Similarly to allopurinol dosing and gout prophylaxis 'failures', I find most patients I see for consultation with this story are not on high enough doses, need combo therapy, or are not on the medication long enough.

• Meth...

In an article by the Yale group, Gallegos et al., PMID 33997256 give a nice summary of the literature cited options for managing cardiac sarcoidosis (Non-steroidal treatment of cardiac sarcoidosis: A systematic review.

Options cited here that have not been discussed include cyclophosphamide, cyclospo...

Very nice review of this disease state with multiple agents I have not used for this condition in the past. I will certainly keep this in mind going forward for those refractory patients with this disease.