Etanercept for refractory ocular sarcoidosis: results of a double-blind randomized trial.

PURPOSES: Study a tumor necrosis factor receptor antagonist (etanercept) in the treatment of chronic ocular sarcoidosis. SUBJECTS AND METHODS: Eighteen patients with ocular sarcoidosis and ongoing inflammation in the eyes. All patients had received at least 6 months of therapy with methotrexate and were currently receiving corticosteroids. Patients were randomized to receive either etanercept, 25 mg subcutaneously twice a week, or placebo in a double-blind randomized trial. Treatment for ocular inflammation with systemic and local corticosteroids at the beginning and end of 6 months of treatment was noted. All patients underwent an ocular examination at the beginning and the end of the study by one ophthalmologist who was unaware of what treatment the patient was receiving. RESULTS: Three of the patients treated with etanercept and one treated with placebo were being treated with lower doses of corticosteroids by the end of the study. However, three of the etanercept patients and one of the placebo patients required larger doses of corticosteroids by the end of the study. The ophthalmology global assessment improved for two of the etanercept-treated patients and three of the placebo-treated patients. CONCLUSION: For most patients, therapy with etanercept was not associated with a significant improvement in their chronic ocular disease.