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Corticosteroids for pulmonary sarcoidosis.

N S Paramothayan1, P W Jones

  • 1Division of Physiological Medicine, St George's Hospital Medical School, Cranmer Terrace, London, UK, SW17 0RE.

The Cochrane Database of Systematic Reviews
|May 5, 2000
PubMed
Summary

Oral steroids improve chest X-rays and global scores in pulmonary sarcoidosis over 6-24 months. Evidence for lung function improvement is limited, and long-term benefits remain unclear.

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Area of Science:

  • Pulmonology
  • Clinical Pharmacology

Background:

  • Pulmonary sarcoidosis is a common condition with an unpredictable course.
  • Corticosteroid therapy is widely used but lacks consensus on optimal use.
  • The long-term benefits and side effects of corticosteroids require further investigation.

Purpose of the Study:

  • To evaluate the evidence from randomized controlled trials (RCTs) on the efficacy of oral and inhaled corticosteroids in treating pulmonary sarcoidosis.

Main Methods:

  • Searched the Cochrane Airways Group interstitial lung disease RCT register and other sources for relevant studies.
  • Included RCTs or controlled clinical trials in adults with histologically confirmed pulmonary sarcoidosis.
  • Assessed study quality and extracted data independently, analyzing outcomes using standard statistical techniques.

Main Results:

  • Four trials with 338 patients showed oral steroids improved chest X-rays and global scores over 6-24 months.
  • Lung function improvements were inconsistent; diffusing capacity showed some benefit in one study.
  • Inhaled steroids showed no effect on chest X-rays, with limited evidence of symptom improvement.

Conclusions:

  • Oral corticosteroids effectively improve chest X-ray and global scores in pulmonary sarcoidosis over 6-24 months.
  • Limited evidence supports lung function improvement; long-term disease modification is unproven.
  • Oral steroids are indicated for moderate-to-severe Stage 2 and 3 disease; inhaled steroids may help with cough symptoms.

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