ERS clinical practice guidelines on treatment of sarcoidosis.

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; ... (2021). ERS clinical practice guidelines on treatment of sarcoidosis. European respiratory journal, 58(6), p. 2004079. European Respiratory Society 10.1183/13993003.04079-2020

Preview	Text Baughman_EurRespirJ_2021_AAM.pdf - Accepted Version Available under License Publisher holds Copyright. Download (6MB) | Preview
	Text Baughman_EurRespirJ_2021.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (1MB)

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.

Interest & Impact

Downloads

74 since deposited on 23 Jun 2021
50 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item