A Guide to Treatment of Sarcoidosis

Not all sarcoidosis patients need treatment. In about 40% of cases, disease will subside spontaneously. For the rest who need to be treated, older drugs like corticosteroids, methotrexate and hydroxychloroquine, as well as the more recent anti-TNF agents, will be effective in suppressing granulomatous inflammation in every organ involved in about 30% of cases. In 20% of the patients, disease will relapse upon discontinuation or tapering of treatment, and in 10% will progress (these two categories constituting chronic disease). In these cases, reinstitution of the same or alternative medication or a combination regimen is warranted. Drugs' side-effects and patients' comorbidities should be taken in consideration during the selection of the appropriate regimen.