The Great Imitator: Updates on Sarcoidosis

Treatment

No medications have been specifically approved for sarcoidosis by the U.S. Food & Drug Administration. However, corticosteroids remain the first-line treatment, with the dose and duration depending on the nature and severity of organ involvement.

Dr. Sharp explained that, for pulmonary involvement, 7.5–15 mg per day of prednisone may be sufficient and changes to therapy should be made slowly over time. Steroid-sparing agents include methotrexate, azathioprine, mycophenolate mofetil, tumor necrosis factor inhibitors and tocilizumab.

Although the field of sarcoidosis still has unmet needs, including the expansion of disease-targeted therapies, hearing from a “sarcoidologist”, such as Dr. Sharp, was helpful for the audience of rheumatologists. This old disease remains highly prevalent and relevant today, and talks like the one given by Dr. Sharp serve to keep the disease in the spotlight and ensure that the diagnosis is considered in all applicable situations.  

Jason Liebowitz, MD, is an assistant professor of medicine in the Division of Rheumatology at Columbia University Vagelos College of Physicians and Surgeons, New York.

References

1. Cozier YC, Berman JS, Palmer JR, et al. Sarcoidosis in Black women in the United States: Data from the Black Women’s Health Study. Chest. 2011 Jan;139(1):144–150.
2. Crowley LE, Herbert R, Moline JM, et al. ‘Sarcoid like’ granulomatous pulmonary disease in World Trade Center disaster responders. Am J Ind Med. 2011 Mar;54(3):175–184.
3. Izbicki G, Chavko R, Banauch GI, et al. World Trade Center ‘sarcoid-like’ granulomatous pulmonary disease in New York City Fire Department rescue workers. Chest. 2007 May;131(5):1414–1423.
4. Cheng RK, Kittleson MM, Beavers CJ, et al. Diagnosis and management of cardiac sarcoidosis: A scientific statement from the American Heart Association. Circulation. 2024 May 21;149(21):e1197–e1216.
5. Sharp M, Psoter KJ, Balasubramanian A, et al. Heterogeneity of lung function phenotypes in sarcoidosis: Role of race and sex differences. Ann Am Thorac Soc. 2023 Jan;20(1):30–37.