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[Treatment of sarcoidosis]
C Londner1, I Zendah, O Freynet
1EA 2363, service de pneumologie, hôpital Avicenne, Assistance publique-Hôpitaux de Paris, université Paris 13, 125, rue de Stalingrad, 93009 Bobigny, France.
La Revue De Medecine Interne
|December 16, 2010
Summary
Sarcoidosis treatment involves corticosteroids for remission, with immunosuppressants, hydroxychloroquine, and infliximab for refractory cases. Long-term monitoring is crucial for sustained recovery in this common, heterogeneous disorder.
Area of Science:
- Pulmonology
- Immunology
- Dermatology
Context:
- Sarcoidosis is a multisystem inflammatory disease with variable severity.
- Corticosteroids are the primary treatment, inducing remission but often requiring long-term management.
- Spontaneous recovery occurs in about half of patients, while others necessitate intervention.
Purpose:
- To outline current treatment strategies for sarcoidosis.
- To identify indications for systemic and topical therapies.
- To discuss the role of corticosteroids, immunosuppressants, and novel agents.
Summary:
- Corticosteroids are the first-line treatment for sarcoidosis, with initial doses of 0.5-1 mg/kg daily, followed by gradual tapering.
- Immunosuppressive drugs like methotrexate and azathioprine are used for corticosteroid-resistant or -intolerant patients.
- Hydroxychloroquine, chloroquine, and infliximab offer alternative options for specific manifestations and refractory cases.
- Topical corticosteroids are effective for localized cutaneous or ocular involvement.
Impact:
- Provides a comprehensive overview of sarcoidosis management guidelines.
- Highlights the importance of individualized treatment approaches based on disease severity and organ involvement.
- Emphasizes the need for long-term monitoring and the development of novel therapies for refractory sarcoidosis.
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