Systemic treatment in sarcoidosis: Experience over two decades

Area of Science:

• Immunology
• Pulmonology
• Rheumatology

Background:

• Sarcoidosis is a multisystem inflammatory disease of unknown etiology.
• Systemic treatment is often required for managing sarcoidosis, but predictors for its necessity are not fully elucidated.

Purpose of the Study:

• To determine the frequency of systemic treatment in a sarcoidosis cohort.
• To identify initial clinical features that predict the need for systemic immunosuppressive therapy.

Main Methods:

• Retrospective analysis of 342 sarcoidosis patients diagnosed between 1999-2019.
• Comparative analysis of treated versus untreated patients.
• Multivariate analysis to identify predictive factors for treatment prescription based on initial clinical manifestations.

Main Results:

• 60.5% of patients required systemic treatment, primarily glucocorticoids.
• Male gender, intrathoracic, ocular, parotid, neurological, and renal involvement were significant risk factors for requiring systemic treatment.
• Conventional immunosuppressants (e.g., methotrexate) and biologics (e.g., adalimumab) were used in 25.4% and 12.9% of treated patients, respectively.

Conclusions:

• A majority of sarcoidosis patients necessitate systemic therapy.
• Initial clinical presentation, including male gender and specific organ involvement, is associated with the need for systemic treatment in sarcoidosis.