The list of treatments mentioned in various sources for Sarcoidosis includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.
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Fortunately, many patients with sarcoidosis require no treatment. Symptoms, after all, are usually not disabling and do tend to disappear spontaneously.
When therapy is recommended, the main goal is to keep the lungs and other affected body organs working and to relieve symptoms. The disease is considered inactive once the symptoms fade. After many years of experience with treating the disease, corticosteroids remain the primary treatment for inflammation and granuloma formation. Prednisone is probably the corticosteroid most often prescribed today. There is no treatment at present to reverse the fibrosis that might be present in advanced sarcoidosis. (Source: excerpt from NHLBI, Sarcoidosis: NHLBI)
Occasionally, a blood test will show a high blood level of calcium accompanying sarcoidosis. The reasons for this are not clear. Some scientists believe that this condition is not common. When it does occur, the patient may be advised to avoid calcium-rich foods, vitamin D, or sunlight, or to take prednisone; this corticosteroid quickly reverses the condition.
Because sarcoidosis can disappear even without therapy, doctors sometimes disagree on when to start the treatment, what dose to prescribe, and how long to continue the medicine. The doctor's decision depends on the organ system involved and how far the inflammation has progressed. If the disease appears to be severe-especially in the lungs, eyes, heart, nervous system, spleen, or kidneys-the doctor may prescribe corticosteroids.
Corticosteroid treatment usually results in improvement. Symptoms often start up again, however, when it is stopped. Treatment, therefore, may be necessary for several years, sometimes for as long as the disease remains active or to prevent relapse.
Frequent checkups are important so that the doctor can monitor the illness and, if necessary, adjust the treatment. Corticosteroids, for example, can have side effects-mood swings, swelling, and weight gain because the treatment tends to make the body hold on to water; high blood pressure; high blood sugar; and craving for food. Long-term use can affect the stomach, skin, and bones. This situation can bring on stomach pain, an ulcer, or acne, or cause the loss of calcium from bones. However, if the corticosteroid is taken in carefully prescribed, low doses, the benefits from the treatment are usually far greater than the problems. (Source: excerpt from NHLBI, Sarcoidosis: NHLBI)
Besides corticosteroids, various other drugs have been tried, but their effectiveness has not been established in controlled studies. These drugs include chloroquine and D-penicillamine.
Several drugs such as chlorambucil, azathioprine, methotrexate, and cyclophosphamide, which might suppress alveolitis by killing the cells that produce granulomas, have also been used. None has been evaluated in controlled clinical trials, and the risk of using these drugs is high, especially in pregnant women.
Cyclosporine, a drug used widely in organ transplants to suppress immune reaction, has been evaluated in one controlled trial. It was found to be unsuccessful. (Source: excerpt from NHLBI, Sarcoidosis: NHLBI)
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Sarcoidosis that produces no symptoms requires no treatment. However, those severely affected with sarcoidosis require treatment with corticosteroids. Such therapy is usually continued for 1 to 2 years, but some patients may need lifelong therapy. Immunosuppressive agents, such as methotrexate, azathioprine, and cyclophosphamide, may also be used. If organ failure occurs (although this is rare), transplantation may be required. Other measures include a low-calcium diet and avoidance of direct exposure to sunlight in patients with hypercalcemia.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Asymptomatic sarcoidosis requires no treatment. However, sarcoidosis that causes ocular, respiratory, CNS, cardiac, or systemic signs and symptoms (such as fever and weight loss) requires treatment with a systemic or topical steroid, as does sarcoidosis that produces hypercalcemia or destructive skin lesions. Such therapy is usually continued for 1 to 2 years, but some patients may need lifelong therapy. Other drugs sometimes used in addition to corticosteroids include immunosuppressants, methotrexate, azathioprine, and cyclophosphamide.
Other treatment includes a low-calcium diet and avoidance of direct exposure to sunlight in patients with hypercalcemia.
Rarely, some individuals with irreversible organ failure require organ transplantation.
Source: Handbook of Diseases, 2003
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