Dept of Medicine, University of Cincinnati Medical Center, Cincinnati, OH 45267, USA.
Eur Respir J. 2013 Jun;41(6):1424-38. doi: 10.1183/09031936.00060612. Epub 2013 Feb 8.
The treatment options for pulmonary sarcoidosis have increased over the past 10 years. As new treatments have been introduced, the best way to assess and compare treatments remains unknown. The goal of this review is to discuss the standard treatments for pulmonary sarcoidosis, including glucocorticoids, and cytotoxic agents, such as methotrexate, azathioprine and leflunomide, and compare them to the newer biological agents, such as infliximab and adalimumab. We also discuss some novel treatments which are currently being evaluated. To compare these different regimens, we look at the measures used to assess response. These include pulmonary function, chest imaging, steroid sparing potential and, more recently, improvements in quality of life measures. While there is, as yet, no standard assessment for response, there is a growing consensus that response to treatment may include improvement of one or more of the following: forced vital capacity, chest imaging and steroid sparing. Several drugs used for pulmonary sarcoidosis have demonstrated improvement in one or more of these measures.
过去 10 年来，治疗肺结节病的选择有所增加。随着新的治疗方法的出现，评估和比较治疗方法的最佳方法仍不清楚。本综述的目的是讨论肺结节病的标准治疗方法，包括糖皮质激素和细胞毒性药物，如甲氨蝶呤、硫唑嘌呤和来氟米特，并将其与较新的生物制剂，如英夫利昔单抗和阿达木单抗进行比较。我们还讨论了一些目前正在评估的新的治疗方法。为了比较这些不同的方案，我们着眼于用于评估反应的措施。这些措施包括肺功能、胸部成像、类固醇节省潜力，以及最近在生活质量方面的改善。虽然目前还没有标准的反应评估，但越来越多的共识认为，治疗反应可能包括以下一种或多种情况的改善：用力肺活量、胸部成像和类固醇节省。几种用于治疗肺结节病的药物已证明在这些措施中的一项或多项有所改善。
