ERS clinical practice guidelines on treatment of sarcoidosis.
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BORIS DOI
Date of Publication
December 2021
Publication Type
Article
Division/Institute
Contributor
Baughman, Robert P | |
Valeyre, Dominique | |
Korsten, Peter | |
Mathioudakis, Alexander G | |
Wuyts, Wim A | |
Wells, Athol | |
Rottoli, Paola | |
Nunes, Hiliaro | |
Lower, Elyse E | |
Judson, Marc A | |
Israel-Biet, Dominique | |
Grutters, Jan C | |
Drent, Marjolein | |
Culver, Daniel A | |
Bonella, Francesco | |
Antoniou, Katerina | |
Martone, Filippo | |
Quadder, Bernd | |
Spitzer, Ginger | |
Nagavci, Blin | |
Rigau, David | |
Ouellette, Daniel R |
Series
European respiratory journal
ISSN or ISBN (if monograph)
0903-1936
Publisher
European Respiratory Society
Language
English
Publisher DOI
PubMed ID
34140301
Description
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 (GC) remain the first choice for initial treatment of symptomatic disease, prolonged use is associated with significant toxicity. GC-sparing alternatives are available. The presented treatment guideline aims to provide guidance to physicians treating the very heterogenous sarcoidosis manifestations.
MATERIALS AND METHODS
A European Respiratory Society Task Force (TF) 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 TF committee delivered twelve recommendations for seven PICOs. These included treatment of pulmonary, cutaneous, cardiac, and neurologic disease as well as fatigue. One PICO question regarding small fiber 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.
MESSAGE
An evidence based guideline for treatment of sarcoidosis is presented. The panel 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.
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 (GC) remain the first choice for initial treatment of symptomatic disease, prolonged use is associated with significant toxicity. GC-sparing alternatives are available. The presented treatment guideline aims to provide guidance to physicians treating the very heterogenous sarcoidosis manifestations.
MATERIALS AND METHODS
A European Respiratory Society Task Force (TF) 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 TF committee delivered twelve recommendations for seven PICOs. These included treatment of pulmonary, cutaneous, cardiac, and neurologic disease as well as fatigue. One PICO question regarding small fiber 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.
MESSAGE
An evidence based guideline for treatment of sarcoidosis is presented. The panel 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.
File(s)
| File | File Type | Format | Size | License | Publisher/Copright statement | Content | |
|---|---|---|---|---|---|---|---|
| Baughman_EurRespirJ_2021_AAM.pdf | Adobe PDF | 6.35 MB | publisher | accepted | |||
| Baughman_EurRespirJ_2021.pdf | Adobe PDF | 1.02 MB | publisher | published |