Income and Other Contributors to Poor Outcomes in U.S. Patients with Sarcoidosis

Comprehensive Care for Patients with Sarcoidosis

“…A Swedish national registry evaluation of 3347 sarcoidosis patients aged 25-59 years, suggested 8% lower income and 26 lost work days in the year of diagnosis compared with age matched controls [20]. In a US registry (n = 2318), 44% of respondents reported a large effect on household finances, and 31% had to quit their job after the diagnosis of sarcoidosis [4].…”

“…For example, medication for sarcoidosis may lead to debilitating side-effects, such as weight gain, diabetes, osteoporosis and psychological problems [38][39][40]. According to one study, patients with higher cumulative doses of prednisolone had a significantly lower QoL when adjusted for disease severity [4,39]. Moreover, medication-related events lead to a substantial number of hospitalizations in patients with sarcoidosis [41].…”

“…A higher number of comorbidities is associated with more frequent hospitalizations and a higher mortality rate [87,88]. The development of new comorbidities, related either to steroid use or to sarcoidosis itself, after the diagnosis of sarcoidosis is independently and strongly associated with a number of adverse outcomes, including worse QoL, risk of hospitalization, and financial impacts [4]. One study showed that more than half of sarcoidosis patients have more than one comorbidity, with arterial hypertension, thyroid disorders and diabetes mellitus being the most prevalent comorbidities [86].…”

“…A study in African-American sarcoidosis patients reported that 90% of patients had one or more comorbidities [89]. The number of comorbidities is higher in older patients, multi-organ involvement and patients with lower incomes [4,86]. Patients with comorbidities obviously have a higher disease complexity, making multidisciplinary management of sarcoidosis even more essential [87].…”

“…Mortality is around 1-5%, and is higher in African-American patients and elderly patients [3]. In general, sarcoidosis leads to a substantial economic burden and societal impact, mainly because of hospitalizations, medication costs and the inability to work [3,4]. For individual patients, high symptom burden often leads to psychological problems and an impaired quality of life (QoL) [5].…”