Daily vs Alternate Day Prednisone Therapy for Stage II Sarcoidosis

Spratling, Larry; Tenholder, Michael F.; Underwood, George H.; Feaster, Brittany; Requa, R.K.

doi:10.1378/chest.88.5.687

Cited by 26 publications

(10 citation statements)

References 7 publications

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“…However, in placebo controlled trials, it is not clear that the response is greater than that seen with placebo [3]. As demonstrated in table 2, the treatment schedule and duration of follow-up leads to differences in response to corticosteroids [14,16,17]. In some studies, an initial improvement was not maintained [32].…”

Section: Pulmonary Functionmentioning

confidence: 99%

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Established and experimental medical therapy of pulmonary sarcoidosis

et al. 2013

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The treatment options for pulmonary sarcoidosis have increased over the past 10 years. As new treatments have been introduced, the best way to assess and compare treatments remains unknown. The goal of this review is to discuss the standard treatments for pulmonary sarcoidosis, including glucocorticoids, and cytotoxic agents, such as methotrexate, azathioprine and leflunomide, and compare them to the newer biological agents, such as infliximab and adalimumab. We also discuss some novel treatments which are currently being evaluated. To compare these different regimens, we look at the measures used to assess response. These include pulmonary function, chest imaging, steroid sparing potential and, more recently, improvements in quality of life measures. While there is, as yet, no standard assessment for response, there is a growing consensus that response to treatment may include improvement of one or more of the following: forced vital capacity, chest imaging and steroid sparing. Several drugs used for pulmonary sarcoidosis have demonstrated improvement in one or more of these measures.

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Section: Pulmonary Functionmentioning

confidence: 99%

“…In addition, there have been several studies which report the short and long term effectiveness of oral glucocorticoids in improving lung function [17,75], although it is not clear that these benefits persist beyond the first year of treatment [79,81].…”

Section: Individual Drugs For Pulmonary Sarcoidosismentioning

confidence: 99%

Established and experimental medical therapy of pulmonary sarcoidosis

et al. 2013

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“…There is no consensus on dose or regime. Alternate day therapy is as effective as daily therapy, but there is no evidence it is better 574. Side effects are significant 575.…”

Section: Sarcoidosismentioning

confidence: 99%

Interstitial lung disease guideline

Wells

Hirani

2008

Thorax

587

223

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“…Anecdotal observation suggests that in some patients, treatment is best continued for at least two years to prevent relapses. Alternate day dosing (with the dose kept equivalent to the average daily dose) has been suggested to limit side-effects18 and shown in a controlled study to be as effective as daily treatment 19. Such a regime is not always practical: diabetic patients may prefer daily dosing to maintain glucose control, and those who have difficulty remembering to take treatment may choose a once daily protocol.…”

Section: Treatment With Oral Corticosteroidsmentioning

confidence: 99%

Management strategies for pulmonary sarcoidosis

Coker

2009

TCRM

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Sarcoidosis is a systemic inflammatory condition with an unexplained predilection for the lung: over 90% of patients have radiographic or physiological abnormalities. Respiratory physicians therefore often manage patients, but any organ may be involved, with noncaseating granulomas the characteristic feature. Sarcoidosis is the commonest interstitial lung disease (ILD), differing from most other ILDs in that many patients remain asymptomatic or improve spontaneously. Careful baseline assessment of disease distribution and severity is thus central to initial management. Subsequently, the unpredictable clinical course necessitates regular monitoring. Sarcoidosis occurs worldwide, with a high prevalence in Afro-Caribbeans and those of Swedish or Danish origin. African Americans also tend to have severe disease. Oral corticosteroids have been used since the 1950s, with evidence of short to medium response; more recent studies have examined the role of inhaled steroids. Long-term benefits of steroids remain uncertain. International guidelines published in 1999 represent a consensus view endorsed by North American and European respiratory societies. Updated British guidelines on interstitial lung disease, including sarcoidosis, were published in 2008. This review describes current management strategies for pulmonary disease, including oral and inhaled steroids, commonly used alternative immunosuppressant agents, and lung transplantation. Tumor necrosis factor alpha inhibitors are briefly discussed.

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Daily vs Alternate Day Prednisone Therapy for Stage II Sarcoidosis

Cited by 26 publications

References 7 publications

Established and experimental medical therapy of pulmonary sarcoidosis

Established and experimental medical therapy of pulmonary sarcoidosis

Interstitial lung disease guideline

Management strategies for pulmonary sarcoidosis

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