Successful therapy with rituximab in three patients with probable neurosarcoidosis

BACKGROUND: Neurosarcoidosis occurs in about 5–15% of patients with sarcoidosis. Therapy with corticosteroids is generally accepted as the first-line medication, followed by various immunomodulating and cytotoxic agents or combined therapy. However, some patients show an unsatisfactory outcome or have adverse events and require novel treatment strategies. METHODS: We describe three patients with systemic sarcoidosis and central nervous system involvement who received CD20-targeted B-cell depletion with rituximab. RESULTS: Treatment with rituximab was well tolerated and followed by marked remission in patients nonresponsive to other immunosuppressive agents. CONCLUSION: Rituximab may be used for patients with neurosarcoidosis who are nonresponsive to established treatment regimes.