[2025年における呼吸器内科の進歩]

Pulmonary sarcoidosis is typically treated with prednisone, but its side effects are prompting the search for alternatives. The PREDMETH study compared methotrexate and prednisone, demonstrating similar efficacy on lung function at 24 weeks. Methotrexate causes fewer metabolic effects but more gastrointestinal and liver disturbances. These results support an alternative approach in sarcoidosis. Non-cystic fibrosis bronchiectasis (NCFBE) has long been limited to repeating what works in cystic fibrosis patients, such as supportive treatments, inhaled antibiotics and macrolides. The first phase 3 trial for a treatment targeting specifically neutrophil inflammation: brensocatib, is presented in this article.