Cardiac sarcoidosis: systematic review of the literature on corticosteroid and immunosuppressive therapies
| Autor: | Virginie Rieu, V. Grobost, Marc Ruivard, Guillaume Le Guenno, Julien Stievenart, Marc André |
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| Přispěvatelé: | Service de Médecine Interne [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Clermont-Ferrand, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Molé, Christine |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
MESH: Sarcoidosis medicine.medical_specialty MESH: Corticosteroids Sarcoidosis medicine.drug_class MEDLINE Cardiac sarcoidosis Cochrane Library 03 medical and health sciences 0302 clinical medicine [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system Adrenal Cortex Hormones Recurrence Internal medicine medicine Humans In patient 030212 general & internal medicine Adverse effect Immunosuppression Therapy business.industry Incidence (epidemiology) medicine.disease 3. Good health [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system 030228 respiratory system Corticosteroid business Atrioventricular block Immunosuppressive Agents |
| Zdroj: | European Respiratory Journal European Respiratory Journal, European Respiratory Society, In press, ⟨10.1183/13993003.00449-2021⟩ European Respiratory Journal, In press, 59 (5), ⟨10.1183/13993003.00449-2021⟩ |
| ISSN: | 1399-3003 0903-1936 |
| Popis: | BackgroundCardiac sarcoidosis (CS) is a life-threatening condition in which clear recommendations are lacking. We aimed to systematically review the literature on cardiac sarcoidosis treated by corticosteroids and/or immunosuppressive agents in order to update the management of CS.MethodsUsing PubMed, Embase and Cochrane Library databases, we found original articles on corticosteroid and standard immunosuppressive therapies for CS that provided at least a fair Scottish Intercollegiate Guidelines Network (SIGN) overall assessment of quality and we analysed the relapse rate, major cardiac adverse events (MACEs) and adverse events. We based our methods on the PRISMA statement and checklist.ResultsWe retrieved 21 studies. Mean quality provided by SIGN assessment was 6.8 out of 14 (range 5–9). Corticosteroids appeared to have a positive impact on left ventricular function, atrioventricular block and ventricular arrhythmias. For corticosteroids alone, nine studies (45%, n=351) provided data on relapses, representing an incidence of 34% (n=119). Three studies (14%, n=73) provided data on MACEs (n=33), representing 45% of MACEs in patients treated by corticosteroid alone. Nine studies provided data on adjunctive immunosuppressive therapy, of which four studies (n=78) provided data on CS relapse, representing an incidence of 33% (n=26). Limitations consisted of no randomised control trial retrieved and unclear data on MACEs in patients treated by combined immunosuppressive agents and corticosteroids.ConclusionCorticosteroids should be started early after diagnosis but the exact scheme is still unclear. Studies concerning adjunctive conventional immunosuppressive therapies are lacking and benefits of adjunctive immunosuppressive therapies are unclear. Homogenous data on CS long-term outcomes under corticosteroids, immunosuppressive therapies and other adjunctive therapies are lacking. |
| Databáze: | OpenAIRE |
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