Sarcoidosis Guidelines

Updated: Feb 09, 2022
  • Author: Nader Kamangar, MD, FACP, FCCP, FCCM; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Guidelines

Guidelines Summary

European Respiratory Society (ERS)

The European Respiaratory Society (ERS) published guidelines for the treatment of sarcoidosis in December 2021. [67] Recommendations include the following:

Pulmonary sarcoidosis

Glucocorticoid treatment to improve and/or preserve forced vital capacity (FVC) and Quality of Life (QoL) is recommended for untreated patients with major involvement from pulmonary sarcoidosis believed to be at higher risk of future mortality or permanent disability.

Adding methotrexate to improve and/or preserve FVC and QoL should be considered for patients with symptomatic pulmonary sarcoidosis treated with glucocorticoids who have continued disease or unacceptable side effects.

Adding infliximab to improve and/or preserve FVC and QoL is suggested for patients with symptomatic pulmonary sarcoidosis who have been treated with glucocorticoids or other immunosuppressive agents and have continued disease.

Cutaneous sarcoidosis

Oral glucocorticoids should be considered for patients with cutaneous sarcoidosis and cosmetically important active skin lesions that cannot be controlled by local treatment.

Adding infliximab to reduce skin lesions is suggested for patients with cutaneous sarcoidosis who have been treated with glucocorticoids and/or other immunosuppressive agents and have continued cosmetically important active skin disease.

Cardiac sarcoidosis

Glucocorticoids (with or without other immunosuppressives) are recommended for patients with evidence of functional cardiac abnormalities, including heart block, dysrhythmias, or cardiomyopathy.

Neurologic disease

Treatment with glucocorticoids is recommended for patients with clinically significant neurosarcoidosis.