Durable remission of cardiac sarcoidosis following discontinuation of methotrexate: A prospective cohort study
Bibliographic record
Abstract
INTRODUCTION: Cardiac sarcoidosis (CS) treatment is challenging due to limited data. Key unknowns include optimal therapies and treatment duration. Data from pulmonary sarcoidosis suggest three disease phenotypes: acute (<1-2 years), chronic, and advanced. Our previous research showed that after a one-year course of corticosteroids, 1/3 of patients did not relapse (acute treatment phenotype), while 2/3 did. This study aims to investigate relapse rates in patients after discontinuation of Methotrexate (MTX). METHODS: This is a single-centre sub-study of the Cardiac Sarcoidosis Multi-Center Prospective Cohort Study (CHASM-CS; NCT01477359). A follow-up PET scan 6-12 months was performed post-MTX discontinuation to assess for relapse. Patients without cardiac relapse were followed clinically thereafter with annual ECGs and echocardiograms. RESULTS: Twelve consecutive MTX responders (mean age: 53.6 ± 8.2 years, 66.6 % female) were included. Mean MTX treatment duration was 44.6 ± 17.6 months. One patient (8.3 %) had recurrent cardiac and extracardiac sarcoidosis, presenting with ventricular tachycardia storm 6.1 months after stopping MTX. Four patients (33.3 %) had recurrent extracardiac sarcoidosis only. Eleven non-cardiac relapsers were followed for an average of 24.9 ± 12.3 months with no adverse clinical events or late relapses. CONCLUSIONS: In 11/12 (91.7 %) patients, CS remained in remission after discontinuation of MTX. These results need replication in larger populations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".