Treatment of sarcoidosis.

Not all patients who have sarcoidosis require treatment. For those who require treatment, the outcome of sarcoidosis can be considered conceptually in three broad, and at least partially overlapping, groupings: acute, chronic, and refractory. Although corticosteroids remain the initial drug for most patients who require therapy, several steroid-sparing alternatives have been found effective in treating many aspects of sarcoidosis. Methotrexate is most commonly used cytotoxic agent used for chronic disease, but azathioprine and leflunomide also have been shown to be useful. The tumor necrosis factor antibody infliximab has proved useful in treating refractory sarcoidosis. These various agents led to a treatment strategy for the various aspects of sarcoidosis.