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Related Experiment Videos

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
|October 18, 2000
PubMed
Summary

Oral corticosteroids improved chest X-rays and global scores in pulmonary sarcoidosis over 6-24 months. However, evidence for maintained benefit on lung function is limited, with no long-term data beyond two years.

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Area of Science:

  • Pulmonary Medicine
  • Respiratory Diseases
  • Clinical Trials

Background:

  • Pulmonary sarcoidosis is a common inflammatory condition with variable progression.
  • Current treatment with oral or inhaled corticosteroids lacks consensus on optimal use.
  • Long-term side effects of corticosteroids necessitate understanding their maintained benefits.

Purpose of the Study:

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

Main Methods:

  • Searched the Cochrane Airways Group interstitial lung disease RCT register for relevant studies.
  • Included RCTs or controlled clinical trials in adults with confirmed pulmonary sarcoidosis.

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  • Assessed study quality and extracted data independently, analyzing outcomes statistically.

    • Main Results:

    • Five RCTs (516 patients) used oral steroids (prednisolone 15-40 mg/day); two RCTs (66 patients) used inhaled steroids (budesonide 0.8-1.2 mg/day).
    • Oral steroids improved chest X-rays and global scores (symptoms, CXR, lung function) over 6-24 months, particularly in Stages 2 and 3 disease.
    • Limited evidence showed lung function improvement; inhaled steroids had minimal impact, though some symptom improvement was noted.

    Conclusions:

    • Oral corticosteroids demonstrate benefit for chest X-ray and global scores in pulmonary sarcoidosis over 6-24 months.
    • Evidence for sustained lung function improvement is weak, and long-term disease modification beyond two years remains unproven.
    • Oral steroids are indicated for moderate-to-severe Stage 2/3 disease; inhaled steroids may help with cough symptoms short-term.