What are your preferred alternative biologic agents for Blau Syndrome when anti-TNFα therapies are contraindicated?

As is true for most of us, I have limited direct clinical experience treating patients with Blau Syndrome. I have treated members of several families and am convinced that corticosteroids are effective and fraught with long-term toxicity. As the question implies, a TNF inhibitor (specifically a mono...

Agree, TNF-i's seem to be the best initial treatment choice for Blau Syndrome (assuming failure of MTX and inability to wean steroids) in terms of efficacy. Importantly, you often need to push the dose quite high, especially in children, and if the patient stops responding, move to another TNF-i and...