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Approach to tapering antisarcoidosis therapy

Ussavarungsi, Kamonpun; Gerke, Alicia K.

Current Opinion in Pulmonary Medicine: September 2019 - Volume 25 - Issue 5 - p 526–532
doi: 10.1097/MCP.0000000000000607
SARCOIDOSIS: Edited by Jan C. Grutters and Marc A. Judson
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Purpose of review Sarcoidosis is a multisystemic granulomatous disease, which commonly affects the lung. The natural course of the disease and prognosis are variable from asymptomatic, spontaneous remission to progressive disease, which requires treatment. Once treatment is initiated, tapering therapy can be problematic.

Recent findings Corticosteroids are recommended as first-line therapy, but optimal regimen and duration of treatment is not well established. Treatment may differ based on severity of disease, extrapulmonary involvement, physician and patient preferences. We reviewed currently recommended regimens, particularly, in pulmonary sarcoidosis and the use of alternative treatments as corticosteroid-sparing agents.

Summary Corticosteroid use is quite effective as initial therapy but is associated with significant side effects. An approach to tapering sarcoidosis therapy is not standardized, given the lack of evidence-based data. This review provides guidance based on the current literature.

Division of Pulmonary and Critical Care, Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA

Correspondence to Kamonpun Ussavarungsi, MD, Division of Pulmonary and Critical Care, Department of Internal Medicine, 200 Hawkins Drive, C33 GH, Iowa City, IA 52242, USA. Tel: +1 319 384 9832; e-mail: kamonpun-ussavarungsi@uiowa.edu

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