First biologic drug commissioned for pulmonary sarcoidosis

In a landmark development, the first biologic drug has been administered to a patient with pulmonary sarcoidosis at the John Radcliffe Hospital, part of Oxford University Hospitals NHS Foundation Trust (OUH). This marks the first new drug approved for this patient group in more than 50 years.

Infliximab, a biologic therapy long used to treat inflammatory conditions such as Crohn's disease and rheumatoid arthritis, has now been commissioned by NHS England (NHSE) for use in pulmonary sarcoidosis. Supported by the National Institute for Health and Care Excellence (NICE), it will be used as an unlicensed/off-label medicine for patients with lung sarcoidosis.

The national commissioning process began in 2016. Professor Ling-Pei Ho, Consultant in Respiratory Medicine at OUH and lead of the Oxford Sarcoidosis Service, chaired the first NHSE working policy group and contributed to the second, which ultimately led to the drug's commissioning.

Sarcoidosis is a condition where the immune system overreacts, causing inflammation and granuloma formation (immune nodules) in various organs, most commonly the lungs. 

It can affect people of all ages and can be particularly severe in some cases. Patients with severe sarcoidosis often require multiple immunosuppressants, which can increase the risk of infections and further complications. Infliximab works by neutralising TNF-α, a protein produced by overactive immune cells in diseases like sarcoidosis and reduces the need for broad immunosuppressants to manage the condition. 

Professor Ho said: "We are very pleased to be able to offer a new medicine for our patients with severe lung sarcoidosis.

"Infliximab offers the potential to reduce reliance on broad immunosuppressants in patients with the progressive and destructive form of lung sarcoidosis."

Simone Hunter, the first patient at Oxford University Hospitals (OUH) to receive the drug, said: "I am excited about the possibility of reducing the number of medications I need. I have been on various immunosuppressants for a long time, and the side effects have started to surface. The commissioning of this drug is very welcome news.

"I have always felt well cared for by the team at OUH. They have been amazing and accessible, and I have great faith in them. I am truly grateful for their hard work in making this treatment a reality."

Professor Andrew Brent, Chief Medical Officer at OUH, said: "This is fantastic news for our patients with lung sarcoidosis. The commissioning of this drug is a great example of our teams' dedication to continually improving patient care. It stands as a testament to their unwavering commitment to achieving the best possible outcomes for our patients."

Pictured: Professor Ling-Pei Ho, Consultant in Respiratory Medicine (left), patient Simone Hunter (front and centre) and Ms Sarah Poole, Advanced Clinical Pharmacist in Respiratory Medicine