Corticosteroids for pulmonary sarcoidosis

Paramothayan, N S; Jones, P. W.

doi:10.1002/14651858.cd001114

Cited by 34 publications

(31 citation statements)

References 24 publications

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“…There is limited evidence that oral steroids alter disease progression and early treatment alters progression of the disease. 16 There is little evidence for the efficacy of inhaled steroids. It is well recognized that sarcoidosis is also commonly an endobronchial disease and can cause a troublesome cough.…”

Section: Cryptogenicmentioning

confidence: 99%

Pulmonary Diseases and Corticosteroids

Sethi

Singhal

2008

Indian J Pediatr

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Steroids (corticosteroids) are anti-inflammatory drugs. Corticosteroids are used in many pulmonary conditions. Corticosteroids have a proven beneficial role in asthma, croup (Laryngotracheobronchitis), decreasing the risk and severity of respiratory distress syndrome (RDS), allergic bronchopulmonary aspergillosis, interstitial lung disease, hemangioma of trachea, Pulmonary eosinophillic disorders. Role of corticosteroids is controversial in many conditions e.g. idiopathic pulmonary hemosiderosis, bronchiolitis, hypersensitivity pneumonitis, hyperplasia of thymus, bronchiolitis, acute respiratory distress syndrome, aspiration syndromes, atypical pneumonias, laryngeal diphtheria, AIDS, SARS, sarcoidosis, meconium aspiration syndrome (MAS), pulmonary haemorrhage, bronchitis, bronchiolitis obliterans with organizing pneumonia in JRA, histiocytosis, alpha-1 antitrypsin deficiency, bordtella pertusis, pulmonary involvement in histiocytosis. However these are used empirically in many of these conditions despite lack of clear evidence in favour. There is concern about their side effects, especially on growth. Systemic steroids are associated with significant adverse effects. Pulmonary conditions have a strategic advantage that inhaled corticosteroids are useful in many of these. Although inhaled preparations of corticosteroids have been developed to maximise effective treatment of lung diseases characterised by inflammation and reduce the frequency of harmful effects, these have not been eliminated. There are situations where only systemic steroids are useful. Clinicians must weigh the benefits against the potential detrimental effects. It is recommended that standard protocols for use of steroids available in literature should be followed, always keeping a watch on the potential hazards of prolonged use.

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Section: Cryptogenicmentioning

confidence: 99%

Pulmonary Diseases and Corticosteroids

Sethi

Singhal

2008

Indian J Pediatr

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“…These patients suffer from unremitting disease activity, (risk of) organ failure and symptoms which severely reduce their quality of life. In these cases, suppression of symptoms is indicated: corticosteroids are the drug of first choice [5][6][7]. Even though corticosteroids are generally effective, they may have severe side effects when chronically used.…”

Section: Introductionmentioning

confidence: 99%

Changes in disease activity, lung function and quality of life in patients with refractory sarcoidosis after anti-TNF treatment

Rijswijk¹,

Vorselaars

Ruven

et al. 2013

Expert Opinion on Orphan Drugs

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“…Im weiteren Verlauf wurden noch mehrere Studien teilweise mit oralen, teilweise mit inhalativen Steroiden durchgeführt [10 -18], die aber alle z. T. erhebliche methodische Schwächen aufweisen. Eine Cochrane-Analyse aus dem Jahr 2005 [19] fasst die Ergebnisse von 13 randomisierten kontrollierten Studien mit über 1000 Patienten zusammen und kommt zu dem Schluss, dass allenfalls in den pulmonalen Stadien II und III Hinweise vorliegen, die eine Steroidgabe rechtfertigen. Hier konnten sowohl radiologische Verbesserungen wie auch Besserungen verschiedener Lungenfunktionsparameter gesehen werden.…”

Section: Pulmonale Sarkoidoseunclassified

Immunsuppressive Therapie der Sarkoidose

Bergner

Löffler

2014

Akt Dermatol

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Zusammenfassung Die Sarkoidose ist eine granulomat?se Systemerkrankung, die nahezu jedes Organsystem betreffen kann. Behandelt wird die Sarkoidose nur bei bestimmten Organmanifestationen oder progredientem Verlauf. Zum Einsatz kommen vor allem Immunsuppressiva. Die Therapie der ersten Wahl sind Kortikosteroide unabh?ngig von der Art der Organmanifestation. Daneben werden in der Literatur nahezu alle vorhandenen Immunsuppressiva auch in der Therapie der Sarkoidose beschrieben. Verwendet wurden unter anderem MTX, Leflunomid, Azathioprin, Cyclosporin, Cyclophosphamid, Mycophenolat-Mofetil, Thalidomid, (Hydroxy-)Chloroquin, Pentoxyphyllin, Ursodeoxychols?ure sowie TNF-?-Blocker und Rituximab. Eingesetzt wurden Immunsuppressiva vor allem zur Einsparung von Kortikosteroiden, aber auch bei therapierefrakt?ren oder lebensbedrohlichen Verl?ufen der Sarkoidose. Die Auswahl des Immunsuppressivums richtet sich dabei nach dem betroffenen Organ. Die Evidenz der meisten Therapien beschr?nkt sich allerdings auf retrospektive Fallserien und Einzelfallberichte. Nur f?r wenige Therapien wurden prospektive Studien durchgef?hrt, die jedoch ?berwiegend nur eine geringe Patientenzahl eingeschlossen haben. Evidenzgrade der Stufen I und II werden fast ausschlie?lich f?r Therapien der pulmonalen und kutanen Sarkoidose erreicht.

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Corticosteroids for pulmonary sarcoidosis

Cited by 34 publications

References 24 publications

Pulmonary Diseases and Corticosteroids

Pulmonary Diseases and Corticosteroids

Changes in disease activity, lung function and quality of life in patients with refractory sarcoidosis after anti-TNF treatment

Immunsuppressive Therapie der Sarkoidose

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