Sarcoidosis Treatment - Cure, Medication, Treatment of Sarcoidosis
Treatment of Sarcoidosis
Many patients with minimal symptoms require no treatment. No curative agent exists. Adrenal corticosteroids are commonly used to suppress potentially serious inflammatory reactions, such as ocular disease, pulmonary parenchymal disease, and central nervous system involvement, and are often effective.
Corticosteroids Therapy in Sarcoidosis Treatment
Corticosteroids can also lower persistently elevated serum calcium levels. Initial doses of 20 to 60 mg prednisone are tapered to the lowest effective maintenance dose. Alternate-day dosage seems effective for maintenance therapy. Objective long-term benefits from corticosteroids have often been difficult to demonstrate, but improved vital capacity, even in severe disease, has been shown in one series. Spontaneous remission can occur. Active articular disease almost always exhibits at least temporary improvement with corticosteroid therapy. When these agents are used, isoniazid coverage may be needed. Because joint disease is often self-limited, however, rest, salicylates, nonsteroidal antiinflammatory drugs and other analgesics are often all that is required.
Salicylates are often not as dramatically effective as in rheumatic fever. Colchicine shortens attacks of acute arthritis in some patients, but it is by no means invariably effective. Methotrexate at 7.5 to 15 mg per week has been effective in several open trials and has been a corticosteroid-sparing agent, but one review found that 15% of patients developed hepatitis.
Chloroquine or hydroxychloroquine have been reported to help cutaneous sarcoidosis and may help some bone sarcoidosis Uncontrolled reports of cyclosporine and azathioprineuse in sarcoidosis have suggested benefit in some patients. Use of tumor necrosis factor inhibitors is under investigation.
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