Hydroxychloroquine as a Steroid-sparing Agent in Extrapulmonary Sarcoidosis

Other criteria

• Inclusion Criteria :; at least 18 years of age; pathologically proven sarcoidosis as defined by the American Thoracic Society (ATS)/European Respiratory Society (ERS)/World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) criteria; non severe ocular sarcoidosis requiring systemic treatment; non severe skin sarcoidosis requiring systemic treatment; non severe osseous sarcoidosis requiring systemic treatment; non severe sarcoidosis with joint involvement requiring systemic treatment; non severe sarcoidosis-related hypercalcemia requiring systemic treatment; non severe peripheral nervous system sarcoidosis requiring systemic treatment; non severe sarcoidosis-related non-severe Ear, Nose and Throat (ENT) involvement requiring systemic treatment; symptomatic hypercalciuria >200 mg/24h (24 h urine) OR; - > 20 mg/mmol creatinine on urine sample; - > 180 mg/g creatinine on urine sample; signed informed consent; affiliated to National French social security system
• Exclusion Criteria :; severe sarcoidosis involvement requiring another immunosuppressant or anti-TNF antibody or methylprednisolone i.v. pulses; previous (<3 months before screening) or concurrent treatment with immunosuppressants; previous treatment with corticoid (patient weaned for 3 months before inclusion); previous treatment with antimalarial drugs (HCQ/CQ) (patient must have been off plaquenil for at least 12 months); treatment with citalopram, escitalopram, hydroxyzin, domperidone and piperaquine; known hypersensitivity or intolerance to HCQ/CQ or 4-aminoquinoline derivatives and prednisone; heart rhythm disorders on EKG (QT prolongation) (except atrial fibrillations); severe ophthalmological impairment or ophthalmological impairment that does not allow ophthalmic monitoring; previous history of maculopathy or retinopathy; end-stage lung, liver, cardiac, or renal disease; sarcoidosis with central nervous system involvement; cardiac sarcoidosis; clinical evidence of active infection (including infection with herpes virus and varicella-zoster virus) or severe/unstabilized comorbidity (e.g. moderate to severe heart failure) or unstabilized psychosis; chronic viral (HIV or HBV) infection; untreated latent/active tuberculosis; pregnancy or lactation (βHCG will be test by blood analysis at inclusion); concurrent vaccination with live vaccines during therapy; inability to understand information about the protocol and to sign informed consent or not suitable candidate to comply with the requirements of this study; patient participating in other interventional research; persons under court protection; Use of effective contraception for the duration of the study . (Contraception is considered effective when it consists of one of the following: use of a male condom during all sexual activity and/or efficient oral hormonal contraception (better considered combined contraception) and/or an intrauterine device (IUD) and/or hormone-releasing intrauterine system (IUS) and/or history of bilateral tubal ligation and/or history of vasectomy, provided the male partner is the trial participant's only sexual partner and/or sexual abstinence)