Daily home spirometry to detect early steroid treatment effects in newly treated pulmonary sarcoidosis

Broos, Caroline E.; Wapenaar, Monique; Looman, Caspar W.N.; Veen, J.C.C.M. in ’t; Toorn, Leon M. van den; Overbeek, Maria J.; Grootenboers, Marco J.J.H.; Heller, Roxane; Mostard, Rémy L M; Poell, Linda H.C.; Hoogsteden, Henk C.; Kool, Mirjam; Wijsenbeek, Marlies; Blink, Bernt van den

doi:10.1183/13993003.02089-2017

Cited by 47 publications

(43 citation statements)

References 15 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For acute exacerbations of sarcoidosis, a prednisone dose of 20 mg/day was found to be adequate 110. The maximal physiologic and symptomatic improvements plateau for most patients within three weeks 131132. Finally, relapses of pulmonary sarcoidosis tend to occur at doses below 15 mg/day 133.…”

Section: Treatment Optionsmentioning

confidence: 99%

New advances in the management of pulmonary sarcoidosis

Culver

Judson

2019

BMJ

View full text Add to dashboard Cite

Sarcoidosis is a highly variable granulomatous multisystem syndrome. It affects individuals in the prime years of life; both the frequency and severity of sarcoidosis are greater in economically disadvantaged populations. The diagnosis, assessment, and management of pulmonary sarcoidosis have evolved as new technologies and therapies have been adopted. Transbronchial needle aspiration guided by endobronchial ultrasound has replaced mediastinoscopy in many centers. Advanced imaging modalities, such as fluorodeoxyglucose positron emission tomography scanning, and the widespread availability of magnetic resonance imaging have led to more sensitive assessment of organ involvement and disease activity. Although several new insights about the pathogenesis of sarcoidosis exist, no new therapies have been specifically developed for use in the disease. The current or proposed use of immunosuppressive medications for sarcoidosis has been extrapolated from other disease states; various novel pathways are currently under investigation as therapeutic targets. Coupled with the growing recognition of corticosteroid toxicities for managing sarcoidosis, the use of corticosteroid sparing anti-sarcoidosis medications is likely to increase. Besides treatment of granulomatous inflammation, recognition and management of the non-granulomatous complications of pulmonary sarcoidosis are needed for optimal outcomes in patients with advanced disease.

show abstract

Section: Treatment Optionsmentioning

confidence: 99%

New advances in the management of pulmonary sarcoidosis

Culver

Judson

2019

BMJ

View full text Add to dashboard Cite

show abstract

“…6,7 Their efficacy has been shown in randomized controlled trials, particularly on pulmonary sarcoidosis. 43 Overall, a response to CS is obtained in 80% to 90% of patients, from a few weeks (3 to 4 weeks in case of lung involvement, 44 4 weeks in case of renal involvement) 45 to 3 months with a complete response often obtained at 6 weeks. 46 Therefore, CS are the preferred first-line treatment since second-line immunosuppressants offer lower response rates and require more time, often 2 to 6 months for a clinical response.…”

Section: What Are Sarcoidosis First-line Treatments?mentioning

confidence: 99%

<p>Refractory Sarcoidosis: A Review</p>

Jammal

Jamilloux

Gerfaud‐Valentin

et al. 2020

TCRM

View full text Add to dashboard Cite

Sarcoidosis is a multi-system disease of unknown etiology characterized by granuloma formation in various organs (especially lung and mediastinohilar lymph nodes). In more than half of patients, the disease resolves spontaneously. When indicated, it usually responds to corticosteroids, the first-line treatment, but some patients may not respond or tolerate them. An absence of treatment response is rare and urges for verifying the absence of a diagnosis error, the good adherence of the treatment, the presence of active lesions susceptible to respond since fibrotic lesions are irreversible. That is when second-line treatments, immunosuppressants (methotrexate, leflunomide, azathioprine, mycophenolate mofetil, hydroxychloroquine), should be considered. Methotrexate is the only first-line immunosuppressant validated by a randomized controlled trial. Refractory sarcoidosis is not yet a well-defined condition, but it remains a real challenge for the physicians. Herein, we considered refractory sarcoidosis as a disease in which second-line treatments are not sufficient to achieve satisfying disease control or satisfying corticosteroids tapering. Tumor necrosis alpha inhibitors, third-line treatments, have been validated through randomized controlled trials. There are currently no guidelines or recommendations regarding refractory sarcoidosis. Moreover, criteria defining non-response to treatment need to be clearly specified. The delay to achieve response to organ involvement and drugs also should be defined. In the past ten years, the efficacy of several immunosuppressants beforehand used in other autoimmune or inflammatory diseases was reported in refractory cases series. Among them, anti-CD20 antibodies (rituximab), repository corticotrophin injection, and anti-JAK therapy anti-interleukin-6 receptor monoclonal antibody (tocilizumab) were the main reported. Unfortunately, no clinical trial is available to validate their use in the case of sarcoidosis. Currently, other immunosuppressants such as JAK inhibitors are on trial to assess their efficacy in sarcoidosis. In this review, we propose to summarize the state of the art regarding the use of immunosuppressants and their management in the case of refractory or multidrugresistant sarcoidosis.

show abstract

“…Use of novel eHealth solutions to enhance self-management has recently gained interest in sarcoidosis [45,51]. Self-monitoring of symptoms, side-effects, QoL, activity and pulmonary function at home has shown to be feasible and highly appreciated by patients with sarcoidosis [51,52]. A comprehensive home monitoring program may provide patients with more insights in their disease course, and thereby empower patients and enhance communication with healthcare providers.…”

Section: Backingmentioning

confidence: 99%

“…A comprehensive home monitoring program may provide patients with more insights in their disease course, and thereby empower patients and enhance communication with healthcare providers. In a recent study, home monitoring of pulmonary function allowed for earlier detection of steroid treatment effects, suggesting that patient-managed steroid dosing regimens may be feasible [52].…”

Section: Backingmentioning

confidence: 99%

Comprehensive Care for Patients with Sarcoidosis

Moor

Kahlmann

Culver

et al. 2020

JCM

Self Cite

View full text Add to dashboard Cite

Sarcoidosis is a multisystem granulomatous disease, associated with significant morbidity and impaired quality of life. Treatment is aimed at recovering organ function, reducing symptom burden and improving quality of life. Because of the heterogeneity and variable disease course, a comprehensive, multidisciplinary approach to care is needed. Comprehensive care includes not only pharmacological interventions, but also supportive measures aimed at relieving symptoms and improving quality of life. The purpose of this review is to summarize the most recent knowledge regarding different aspects of care and propose a structured approach to sarcoidosis management.

show abstract

Daily home spirometry to detect early steroid treatment effects in newly treated pulmonary sarcoidosis

Cited by 47 publications

References 15 publications

New advances in the management of pulmonary sarcoidosis

New advances in the management of pulmonary sarcoidosis

<p>Refractory Sarcoidosis: A Review</p>

Comprehensive Care for Patients with Sarcoidosis

Contact Info

Product

Resources

About