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Pharmacotherapy for pulmonary sarcoidosis: a Delphi consensus study.
Amanda C Schutt1, Wendy M Bullington, Marc A Judson
1Medical University of South Carolina Medical Center and College of Pharmacy, Charleston, SC 29425, USA.
Respiratory Medicine
|January 22, 2010
Summary
Pulmonary sarcoidosis treatment consensus was reached on initial corticosteroid therapy and methotrexate as a second-line drug. However, optimal corticosteroid dosing and treatment timing for mild cases remain unresolved.
Area of Science:
- Pulmonology
- Rheumatology
- Clinical Pharmacology
Background:
- Pulmonary sarcoidosis pharmacotherapy lacks established clinical trial guidelines.
- Expert opinion is crucial for unresolved treatment issues.
Purpose of the Study:
- To survey pulmonary sarcoidosis experts on treatment strategies.
- To reach expert consensus on managing pulmonary sarcoidosis using the Delphi method.
Main Methods:
- A 6-item questionnaire was developed and administered to experts.
- Three rounds of Delphi method questionnaires were used, incorporating feedback and literature.
- Experts were identified from the Diffuse Lung Disease Network at the CHEST meeting.
Main Results:
- Consensus was achieved on corticosteroids as first-line therapy and methotrexate as preferred second-line.
- Recommended maximum dose for acute pulmonary sarcoidosis: 40mg daily prednisone equivalent.
- Successful taper for chronic pulmonary sarcoidosis: 10mg daily prednisone equivalent.
Conclusions:
- Expert consensus provides appropriate therapeutic approaches for several pulmonary sarcoidosis treatment aspects.
- Unresolved issues highlight the need for further clinical research in pulmonary sarcoidosis pharmacotherapy.
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