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Difficult treatment issues in sarcoidosis
Author(s) -
Baughman R. P.,
Lynch J. P.
Publication year - 2003
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1046/j.1365-2796.2003.01076.x
Subject(s) - medicine , sarcoidosis , hydroxychloroquine , azathioprine , cutaneous sarcoidosis , asymptomatic , thalidomide , neurosarcoidosis , infliximab , disease , methotrexate , intensive care medicine , adalimumab , ustekinumab , dermatology , covid-19 , multiple myeloma , infectious disease (medical specialty)
. Baughman RP, Lynch JP (University of Cincinnati, Cincinnati, OH, USA; University of Michigan, AnnArbor, MI, USA). Difficult treatment issues in sarcoidosis (Minisymposium). J Intern Med 2003; 253: 41–45. The management of sarcoidosis includes several crucial decisions. Not all patients with sarcoidosis need treatment. At least a third of patients will never be treated. It is unclear whether asymptomatic patients ever need therapy, even if they have extensive lung disease. One reason that clinicians are reluctant to start therapy is that many patients who are started on corticosteroids have a difficult time getting off therapy, even after 2 years. In the chronic patient, alternatives to corticosteroids have been developed. These include drugs such as methotrexate, azathioprine and hydroxychloroquine. These agents have been the standard second line of therapy for patients with chronic disease. However, these drugs do not always work. In addition, they are associated with their own toxicities. Another group of sarcoidosis patients have also emerged. These are the refractory patients, who have progressive disease whilst on therapy. For these patients, new agents such as thalidomide and the monoclonal antibodies to tumour necrosis factor have been occasionally helpful. This paper reviews several important issues in the management of sarcoidosis.