Treatment of Sarcoidosis: Grading the evidence.

Treatment of Sarcoidosis: Grading the evidence. Expert Rev Clin Pharmacol. 2018 Jun 08;: Authors: James WE, Baughman R Abstract INTRODUCTION: Treatment of sarcoidosis recommendations are often based on clinical experience and expert opinion. However, there are an increasing number of studies which are providing evidence to support decisions regarding treatment. Areas Covered: Several studies have identified factors associated with increased risk for organ failure or death ("danger"). There have been several studies focused on the role of treatment to improve quality of life for the patient. Sarcoidosis treatment often follows a progression, based on response. Corticosteroids remain the initial treatment of choice for most patients. Second line therapy includes cytotoxic agents. Immunosuppressives such as methotrexate, azathioprine, leflunomide, and mycophenolate have all been reported as effective in sarcoidosis. Biologics and other agents are third line therapy. The monoclonal antibodies directed against tumor necrosis factor have been shown to be particularly effective for advanced disease. Infliximab has been the most studied drug in this class. Newer treatments, including repository corticotropin injection and rituximab have been reported as effective in some cases. Expert Commentary: In this review, we use the GRADE system to evaluate the currently available evidence and make recommendations regarding treatment. PMID: 29883224 [PubMed -...
Source: Expert Review of Clinical Pharmacology - Category: Drugs & Pharmacology Tags: Expert Rev Clin Pharmacol Source Type: research

Related Links:

CONCLUSIONS: Knowledge of this toxicity is crucial as the clinical signs and radiological patterns may suggest tumour progression. PMID: 30220489 [PubMed - as supplied by publisher]
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Tags: Rev Mal Respir Source Type: research
Endocrine Practice, Ahead of Print.
Source: Endocrine Practice - Category: Endocrinology Authors: Source Type: research
Endocrine Practice, Ahead of Print.
Source: Endocrine Practice - Category: Endocrinology Authors: Source Type: research
AbstractNeurosarcoidosis is relatively rare and has diverse manifestations. The clinical characteristics, diagnosis, treatment, and outcome for neurosarcoidosis in China are poorly understood. We retrospectively analyzed the clinical features, laboratory and imaging results, treatment, and outcomes in patients who met the criteria for definite or probable neurosarcoidosis in Xuan Wu Hospital of Capital Medical University from 2000 to 2015. Eight patients were included in this study, accounting for 5.84% of all cases with sarcoidosis. The mean age at onset was 50.25  years, and 75% of the patients were female. Five cas...
Source: Neurological Sciences - Category: Neurology Source Type: research
ConclusionNecrotising retinopathy-like lesions mimicking an infectious process or a lymphoproliferative disorder can be an atypical manifestation of ocular sarcoidosis.
Source: Journal of Ophthalmic Inflammation and Infection - Category: Opthalmology Source Type: research
Purpose of review Sarcoidosis is a chronic disease, which is routinely treated with corticosteroids. Steroid resistance or steroid-induced adverse effects require alternatives. Other immune-modulating pharmacological treatments have been developed, and therefore expanded tremendously. Until now, the role of nutrition in the overall management of sarcoidosis has been neglected although anti-inflammatory properties of nutritional components have been known for many years now. New nutritional possibilities emerge from already existing data and offer new therapeutic avenues in the treatment of sarcoidosis. Recent findings ...
Source: Current Opinion in Pulmonary Medicine - Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Peter Korsten and Marjolein Drent Source Type: research
Purpose of review Sarcoidosis is a multisystem disease of unknown cause. Obesity can affect many physiological factors. The relationship between obesity and sarcoidosis is unclear, and can been described as posing a ‘chicken and egg’ scenario for the patient as it is not always clear whether it is a consequence of, or a risk factor for any disease. The purpose of this review is to examine the dual roles of obesity on sarcoidosis morbidity and the incidence. Recent findings Obesity magnifies the symptoms of sarcoidosis and corticosteroid therapy increases BMI. Prospective epidemiologic studies started to ex...
Source: Current Opinion in Pulmonary Medicine - Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Peter Korsten and Marjolein Drent Source Type: research
Rationale: Diagnostic difficulty due to overlapped clinical findings exists in cardiac sarcoidosis (CS) patients who also have coronary artery disease. Since cardiac magnetic resonance (CMR) and fluorodeoxyglucose-positron emission tomography (FDG-PET) evaluate different pathological processes, that is, fibrosis and inflammation respectively, the combination may be useful in such a case. Patient concerns: A 77-year-old man was admitted due to heart failure and advanced atrioventricular block who was previously diagnosed with cutaneous sarcoidosis and old myocardial infarction (MI) with angiographical evidence. Diagno...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
CONCLUSIONS: The evidence supporting the management of chronic cough in ILD is limited. This guideline presents suggestions for managing and treating cough on the best available evidence but future research is clearly needed. PMID: 30036496 [PubMed - as supplied by publisher]
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
This article begins with an illustrative case vignette, followed by an overview of the syndrome and current theories regarding its pathogenesis.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
More News: Corticosteroid Therapy | Drugs & Pharmacology | Methotrexate | Remicade | Rituxan | Sarcoidosis | Study