Current treatment of sarcoidosis

Curr Opin Pulm Med. 2020 Sep;26(5):591-597. doi: 10.1097/MCP.0000000000000720.

Abstract

Purpose of review: Sarcoidosis is a granulomatous systemic disease of unknown cause where the lung is the most frequently affected organ. Therapeutic management of the disease is challenging as clinical presentation and prognosis are very heterogeneous. In the present review, we will summarize the main advances in sarcoidosis therapy.

Recent findings: Current sarcoidosis therapies are categorized in three lines: glucocorticoids (first line), immunosuppressants (second line), and biologics (third line). Recent glucocorticoid studies have reported that efficacy could be similar with high and low doses, but with an increase in side effects with higher doses. In immunosuppressants, recent publications in mycophenolate and repository corticotropin injection (RCI) have added more information in their use and efficacy. Finally, new evidence has been published in the use of antitumor necrosis factor (anti-TNFα) agents in refractory cardiac sarcoidosis and neurosarcoidosis.

Summary: Sarcoidosis therapy is constantly evolving, and new drugs have been added to the recommended treatments. However, extensive clinical trials are still necessary to optimize the current recommendations.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biological Products / therapeutic use*
  • Cardiomyopathies / drug therapy
  • Central Nervous System Diseases / drug therapy
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Lung
  • Prognosis
  • Sarcoidosis / drug therapy*
  • Sarcoidosis, Pulmonary / drug therapy
  • Tumor Necrosis Factor Inhibitors / therapeutic use

Substances

  • Biological Products
  • Glucocorticoids
  • Immunosuppressive Agents
  • Tumor Necrosis Factor Inhibitors

Supplementary concepts

  • Neurosarcoidosis