Sarilumab in Patients With Glucocorticoid-Dependent Sarcoidosis

Inclusion Criteria:

   - Biopsy proven non-caseating granulomas consistent with sarcoidosis

   - negative infectious studies including AFB and fungal stains, and with compatible
   clinical and/or radiographic manifestations of sarcoidosis.

   - Involvement of the lungs (stage II or III pulmonary sarcoidosis), lymph nodes, liver,
   kidneys, spleen, bone, soft tissues, skin, and/or eyes.

   - At least one active manifestation, defined by the need for ongoing glucocorticoid
   treatment to control a sign or symptom of sarcoidosis, which requires treatment with
   prednisone (or equivalent corticosteroid) ≥ 10 mg and ≤ 60 mg daily (i.e.
   glucocorticoid dependence), with stable dosing for ≥ 28 days prior to baseline.

   - patients taking a glucocorticoid other than prednisone, will be changed to prednisone
   at the equivalent dose and take this daily for ≥ 14 days prior to baseline.

   - DMARDs including methotrexate, leflunomide, azathioprine, mycophenolate mofetil,
   and/or anti-malarials (i.e. hydroxychloroquine) permitted must be stable for ≥ 28 days
   prior to baseline and remain stable during follow-up.

Exclusion Criteria:

   - Stage IV pulmonary sarcoidosis.

   - Central nervous system sarcoidosis.

   - Cardiac sarcoidosis.

   - Prior treatment with an anti-IL-6 therapy.

   - Treatment with a biologic agent including rituximab, belimumab, TNF inhibitors,
   abatacept, or IL-17 inhibitors administered within 28 days prior to baseline (6 months
   for rituximab).

   - Treatment with cyclophosphamide within 3 months prior to baseline.

   - Treatment with prednisone < 10 mg or > 60 mg daily.

   - Known hypersensitivity or allergy to the study drug.

   - History of, or current, inflammatory or autoimmune disease other than sarcoidosis
   which would present a safety issue or confound interpretation of the data.

   - Prior or current history of other significant concomitant illness that, according to
   the investigator's judgment, would adversely affect the patient's participation in the
   study. These include, but are not limited to, cardiovascular (including stage III or
   IV cardiac failure according to the New York Heart Association classification),
   neurological (including demyelinating disease), active infectious diseases, or history
   of diverticulitis or gastrointestinal perforation.

   - Patients currently pregnant or breast-feeding.

   - Women of childbearing potential (WOCBP) who are unwilling to utilize adequate
   contraception and unwilling to not become pregnant during the full course of the study
   (must be willing to be tested for pregnancy). Adequate contraceptive measures include
   oral contraceptives (continuous use, as per prescription, for 2 or more cycles prior
   to screening), intrauterine devices, contraceptive sponges, condoms or diaphragms plus
   foam, or jelly, or surgical procedures such as bilateral tubal ligation or vasectomy
   in partner.

   - Administration of a live/attenuated vaccine within 30 days.

   - Evidence of active tuberculosis, HIV, or hepatitis B or C infection.

   - History of cancer other than non-melanoma skin cancer.

   - Patients with any of the following laboratory abnormalities at the screening visit:
   hemoglobin <8.5 g/dL, white blood cells <3000/mm3, neutrophils <2000/mm3, platelet
   count <150,000 cells/mm3, aspartate aminotransferase (AST) or ALT >1.5 x ULN, and/or
   bilirubin (total) above the upper limit of normal (unless Gilbert's disease has been
   determined by genetic testing and documented).

   - Presence of severe uncontrolled hypercholesterolemia (>350 mg/dL, 9.1 mmol/L) or
   hypertriglyceridemia (>500 mg/dL, 5.6 mmol/L) at screening or baseline.

   - Patients with calculated creatinine clearance <30 mL/minute (using Cockroft-Gault
   formula).

   - History of alcohol or drug abuse within 5 years prior to the screening visit.

   - Participation in any clinical research study evaluating another investigational drug
   or therapy within 5 half-lives or 60 days of first investigational medicinal product
   (IMP) administration, whichever is longer.

   - Any patient who has had surgery within 4 weeks prior to the screening visit or with
   planned surgery during the course of the study.