Synthetic pharmacotherapy for pulmonary sarcoidosis

Expert Opin Pharmacother. 2019 Aug;20(11):1397-1404. doi: 10.1080/14656566.2019.1615054. Epub 2019 May 15.

Abstract

Introduction: Sarcoidosis is a granulomatous systemic disease of unknown cause where the lungs are the most frequently affected. Therapeutic management of the disease is challenging as clinical presentation and prognosis are very heterogeneous.

Areas covered: This review summarizes the current knowledge of synthetic therapies for pulmonary sarcoidosis. The most commonly used medication for the treatment of sarcoidosis with lung involvement are glucocorticoids. Nevertheless, not all patients reach an acceptable response or tolerate them and the use of second-line treatments like immunosuppressive agents are necessary. Other kind of drugs could be used but there is no solid evidence and most of them are currently under investigation.

Expert opinion: The majority of patients with pulmonary sarcoidosis do not require treatment and their sarcoidotic lung lesions could regress. However, it is important to treat the disease in those cases that could develop organ failure. Although the number of studies of therapies for pulmonary sarcoidosis have increased in recent years, the information available is still limited and there is no consensus on how to monitor the activity of the disease.

Keywords: Glucocorticoids; Immunosuppressive Therapy; Pulmonary Sarcoidosis.

Publication types

  • Review

MeSH terms

  • Antimalarials / therapeutic use
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Parenchymal Tissue / diagnostic imaging
  • Remission, Spontaneous
  • Sarcoidosis, Pulmonary / drug therapy*
  • Sarcoidosis, Pulmonary / pathology
  • Steroids / therapeutic use

Substances

  • Antimalarials
  • Glucocorticoids
  • Immunosuppressive Agents
  • Steroids