Table 4– Outcome of treatment for pulmonary sarcoidosis treated with alternatives to glucocorticoids

Drug	Design	Subjects n	FVC	D_LCO	Chest radiography	Quality of life	Steroid sparing	Other	First Author [ref.]
Methotrexate
Prednisone plus methotrexate or placebo	DBPCRT	24	ns				Yes	Weight gain less with methotrexate	Baughman [20]
Methotrexate	OL	50	44% have >10% improvement in FVC				Yes		Lower [38]
Methotrexate	OL	91	80% improvement in FEV₁ >10%	65% improvement >10%					Vucinic [88]
Methotrexate	OL	192						Benefit 67%^#	Baughman [89]
Azathioprine
Azathioprine plus prednisolone	OL	11	Yes		Better by comparison				Muller-Quernheim [21]
Azathioprine	OL	35						Benefit 54%^#	Baughman [89]
Azathioprine	OL	10	ns	ns				2/10 had >10% improvement in FVC	Lewis [90]
Leflunomide
Leflunomide	OL	16					Yes	12/16 has complete or partial response^¶	Baughman [91]
Leflunomide	OL	33	Yes	ns			Yes		Sahoo [25]
Anti-TNF agents
Infliximab in addition to current therapy	DBPCRT	138	Yes		Improvement in Muers' R-score	SGRQ, SF-36 ns			Baughman [28]
Infliximab in addition to current therapy	DBPCRT	19	Yes		Comparison ns	SF-36 ns			Rossman [30]
Adalimumab in addition to current therapy	OL	8		Yes				Eight patients with reduced D_LCO prior to therapy	Erckens [92]
Adalimumab in addition to current therapy	OL	10	ns			SF-36 Physical Yes			Milman [58]
Adalimumab in addition to current therapy	OL	5	ns						Kamphius [93]
Etanercept alone	OL	17						Study terminated early because of treatment failure in 12 patients	Utz [94]
Other agents
Pentoxifylline alone	OL	23	ns	Yes				11 patients felt to improve	Zabel [24]
Pentoxifylline plus prednisone	DBPCRT	27					Trend to favour active drug	No difference in rate of change in pulmonary parameters	Park [15]
Thalidomide plus prednisone	OL	10	ns			SF-36 ns	3/10 patients		Judson [26]
Thalidomide in addition to current therapy	OL	12	ns						Baughman [95]
Chloroquine alone	OL	23	Yes	Yes	12/19 improved by comparison				Baltzan [23]
Prednisone plus Cyclosporin A versus placebo	OLRT	37	No⁺		ns				Wyser [22]
Vasoactive intestinal peptide alone	OL	20	ns	ns					Prasse [27]

FVC: forced vital capacity; D_LCO: diffusion capacity of the lung carbon monoxide; DBPCRT: double-blind, placebo-controlled, randomised trial; ns: nonsignificantly different from control; OL: open label; FEV₁: forced expiratory volume in 1 s; TNF; tumour necrosis factor; SGRQ: St George’s Respiratory Questionnaire; SF-36: Short form-36; OLRT: open label randomised trial. ^#: disease regression and/or reduction in prednisone dosage to ≤10 mg·day⁻¹ or equivalent; ^¶: greater than 50% reduction of maximal disease; ⁺: significant difference from pretreatment for both groups.