RT Journal Article
SR Electronic
T1 ERS clinical practice guidelines on treatment of sarcoidosis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2004079
DO 10.1183/13993003.04079-2020
VO 58
IS 6
A1 Robert P. Baughman
A1 Dominique Valeyre
A1 Peter Korsten
A1 Alexander G. Mathioudakis
A1 Wim A. Wuyts
A1 Athol Wells
A1 Paola Rottoli
A1 Hiliaro Nunes
A1 Elyse E. Lower
A1 Marc A. Judson
A1 Dominique Israel-Biet
A1 Jan C. Grutters
A1 Marjolein Drent
A1 Daniel A. Culver
A1 Francesco Bonella
A1 Katerina Antoniou
A1 Filippo Martone
A1 Bernd Quadder
A1 Ginger Spitzer
A1 Blin Nagavci
A1 Thomy Tonia
A1 David Rigau
A1 Daniel R. Ouellette
YR 2021
UL http://erj.ersjournals.com/content/58/6/2004079.abstract
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