Anti-Granulomatous Therapy for Pulmonary Sarcoidosis

Abstract

Sarcoidosis is a systemic disease of granulomatous inflammation that predominately affects the lungs. The cause is unknown. Although over half of cases spontaneously resolve, a large proportion of patients require therapy for progressive symptoms or worsening organ function. Corticosteroids remain first-line therapy, but steroid-sparing medications should be considered in high-risk cases. In this chapter, we review types of therapies targeted to the granulomatous inflammatory pathway and their role in treatment of sarcoidosis. Because of the complex interaction of patient factors and medication toxicities, appropriate clinical management should include a personalized discussion with each patient to determine the individual treatment plan. Future trials are needed to test novel drugs and establish less toxic approaches to therapy.