New Therapies for Sarcoidosis: Molecular and Pathophysiological Basis
Fotios Drakopanagiotakis1, Ilias Papanikolaou2, Theodoros Panou1
1Department of Pneumonology, Medical School, Democritus University of Thrace, University General Hospital Dragana, 68100 Alexandroupolis, Greece.
International Journal of Molecular Sciences
|June 26, 2026
Summary
New research explores targeted treatments for sarcoidosis, a complex inflammatory disease. Advances in understanding its mechanisms guide the development of steroid-sparing therapies, improving patient outcomes.
Area of Science:
- Immunology
- Pathobiology
- Pharmacology
Background:
- Sarcoidosis is a multisystem granulomatous disease with significant treatment challenges.
- Long-term corticosteroid use, while effective, leads to adverse effects.
- Emerging research reveals key molecular pathways involved in sarcoidosis.
Purpose of the Study:
- To connect sarcoidosis pathobiology to novel targeted therapies.
- To review clinical trial evidence for emerging treatments.
- To propose future directions for individualized, biomarker-driven care.
Main Methods:
- Review of molecular mechanisms including JAK-STAT and mTOR signaling.
- Analysis of clinical trial data for methotrexate, efzofitimod, and JAK inhibitors.
- Incorporation of the 2025 World Association for Sarcoidosis and Other Granulomatoses (WASOG) statement.
Main Results:
- Methotrexate is validated as a first-line steroid-sparing agent.
- Janus kinase (JAK) inhibitors show promise in various sarcoidosis presentations.
- Efzofitimod demonstrated steroid-reducing effects in Phase II but not Phase III trials.
Conclusions:
- The understanding of sarcoidosis pathogenesis is rapidly advancing.
- There is a growing trend towards earlier steroid-sparing treatment strategies.
- Future care will likely involve individualized approaches guided by biomarkers.
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