ERS clinical practice guidelines on treatment of sarcoidosis
| Autor: | Jan C. Grutters, Alexander G. Mathioudakis, Ginger Spitzer, Bernd Quadder, Marc A. Judson, Daniel A. Culver, Thomy Tonia, Elyse E. Lower, Robert P. Baughman, Peter Korsten, Francesco Bonella, Athol U. Wells, Dominique Israël-Biet, Dominique Valeyre, Katerina M. Antoniou, Hiliaro Nunes, Daniel R. Ouellette, Filippo Martone, Marjolein Drent, Wim A. Wuyts, David Rigau, Paola Rottoli, Blin Nagavci |
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| Přispěvatelé: | Faculteit FHML Centraal, RS: FHML non-thematic output |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Sarcoidosis Medizin MEDLINE Disease 030204 cardiovascular system & hematology PLACEBO-CONTROLLED TRIAL 03 medical and health sciences 0302 clinical medicine LEFT-VENTRICULAR DYSFUNCTION Quality of life LONG-TERM OUTCOMES QUALITY-OF-LIFE Intervention (counseling) medicine Humans Intensive care medicine Grading (education) Fatigue business.industry LATE GADOLINIUM ENHANCEMENT Guideline SMALL FIBER NEUROPATHY medicine.disease Sarcoidosis/diagnosis BRITISH-THORACIC-SOCIETY 3. Good health Clinical Practice 030228 respiratory system Quality of Life CHRONIC CUTANEOUS SARCOIDOSIS F-18 FDG-PET/CT DOSE METHOTREXATE THERAPY business |
| Zdroj: | EUROPEAN RESPIRATORY JOURNAL r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname European Respiratory Journal, 58(6):2004079. European Respiratory Society |
| ISSN: | 0903-1936 |
| DOI: | 10.1183/13993003.04079-2020 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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