PT  - JOURNAL ARTICLE
AU  - Baughman, Robert P.
AU  - Valeyre, Dominique
AU  - Korsten, Peter
AU  - Mathioudakis, Alexander G.
AU  - Wuyts, Wim A.
AU  - Wells, Athol
AU  - Rottoli, Paola
AU  - Nunes, Hiliaro
AU  - Lower, Elyse E.
AU  - Judson, Marc A.
AU  - Israel-Biet, Dominique
AU  - Grutters, Jan C.
AU  - Drent, Marjolein
AU  - Culver, Daniel A.
AU  - Bonella, Francesco
AU  - Antoniou, Katerina
AU  - Martone, Filippo
AU  - Quadder, Bernd
AU  - Spitzer, Ginger
AU  - Nagavci, Blin
AU  - Tonia, Thomy
AU  - Rigau, David
AU  - Ouellette, Daniel R.
TI  - ERS clinical practice guidelines on treatment of sarcoidosis
AID  - 10.1183/13993003.04079-2020
DP  - 2021 Dec 01
TA  - European Respiratory Journal
PG  - 2004079
VI  - 58
IP  - 6
4099  - http://erj.ersjournals.com/content/58/6/2004079.short
4100  - http://erj.ersjournals.com/content/58/6/2004079.full
SO  - Eur Respir J2021 Dec 01; 58
AB  - Background The major reasons to treat sarcoidosis are to lower the morbidity and mortality risk or to improve quality of life (QoL). The indication for treatment varies depending on which manifestation is the cause of symptoms: lungs, heart, brain, skin or other manifestations. While glucocorticoids remain the first choice for initial treatment of symptomatic disease, prolonged use is associated with significant toxicity. Glucocorticoid-sparing alternatives are available. The presented treatment guidelines aim to provide guidance to physicians treating the very heterogenous sarcoidosis manifestations.Methods A European Respiratory Society Task Force committee composed of clinicians, methodologists and patients with experience in sarcoidosis developed recommendations based on the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology. The committee developed eight PICO (Patients, Intervention, Comparison, Outcomes) questions and these were used to make specific evidence-based recommendations.Results The Task Force committee delivered 12 recommendations for seven PICOs. These included treatment of pulmonary, cutaneous, cardiac and neurologic disease as well as fatigue. One PICO question regarding small-fibre neuropathy had insufficient evidence to support a recommendation. In addition to the recommendations, the committee provided information on how they use alternative treatments, when there was insufficient evidence to support a recommendation.Conclusions There are many treatments available to treat sarcoidosis. Given the diverse nature of the disease, treatment decisions require an assessment of organ involvement, risk for significant morbidity, and impact on QoL of the disease and treatment.Evidence-based guidelines for the treatment of sarcoidosis are presented. The ERS Task Force committee used the GRADE approach and specific recommendations are made. A major factor in treating patients is the risk of loss of organ function or impairment of quality of life. https://bit.ly/3iAERfY