Overview
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).
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.
Eligibility
Inclusion Criteria:
- Biopsy-proven diagnosis of sarcoidosis with demonstrated pulmonary involvement
- Refractoriness to or intolerance of immunosuppressive agents like prednisone or methotrexate
Exclusion Criteria:
- Smoking
- Cancer
- Chronic infections (e.g. tuberculosis, viral, fungal, bacterial)
- Inflammatory conditions
- Coexisting lung disease
- Congestive heart failure
- Uncontrolled hypertension
- Recent surgery
- Active peptic ulcers
- Osteoporosis