A Comprehensive Review of Sarcoidosis Treatment for Pulmonologists
| Autor: | Elena Bargagli, Flora Anna Cimmino, Caterina Bigliazzi, Laura Bergantini, Andrea S. Melani |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Sarcoidosis Azathioprine Review Adalimumab Anti-TNF Corticosteroids Infliximab Methotrexate Treatment Pharmacotherapy Prednisone Respiratory Care medicine Intensive care medicine Pulmonologists business.industry medicine.disease business medicine.drug |
| Zdroj: | Pulmonary Therapy |
| Popis: | Due to frequent lung involvement, the pulmonologist is often the reference physician for management of sarcoidosis, a systemic granulomatous disease with a heterogeneous course. Treatment of sarcoidosis raises some issues. The first challenge is to select patients who are likely to benefit from treatment, as sarcoidosis may be self-limiting and remit spontaneously, in which case treatment can be postponed and possibly avoided without any significant impact on quality of life, organ damage or prognosis. Systemic glucocorticosteroids (GCs) are the drug of first choice for sarcoidosis. When GCs are started, there is a > 50% chance of long-term treatment. Prolonged use of prednisone at > 10 mg/day or equivalent is often associated with severe side effects. In these and refractory cases, steroid-sparing options are advised. Antimetabolites, such as methotrexate, are the second-choice therapy. Biologics, such as anti-TNF and especially infliximab, are third-choice drugs. The three treatments can be used concomitantly. Regardless of whether treatment is started, the clinician needs to organize regular follow-up to monitor remissions, flares, progression, complications, toxicity and relapses in order to promptly adjust the drugs used. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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