Vorselaars Adriane D M, van Moorsel Coline H M, Deneer Vera H M, Grutters Jan C
Centre of Interstitial Lung Diseases, Department of Pulmonology, St. Antonius Hospital, Koekoekslaan 1 3435 CM Nieuwegein, The Netherlands.
Inflamm Allergy Drug Targets. 2013 Dec;12(6):369-77. doi: 10.2174/18715281113126660062.
Sarcoidosis is a systemic, granulomatous disease that can affect multiple organs and has a variable clinical course. Corticosteroids (e.g. prednisone) remain the mainstay of therapy in sarcoidosis since their first use in this disease in the 1950s. A second-line therapeutic is often added to the treatment regimen in case of intolerable side effects, inefficacy or prolonged use of steroids. Methotrexate is considered by many to be the first choice drug in second-line therapeutics of sarcoidosis. Other often used second-line drugs are azathioprine and leflunomide. No large trials comparing different treatment options have been performed in sarcoidosis. In patients with severe disease who do not respond well to first and second-line therapy, biologicals such as infliximab can be promising. In this review, we provide a complete overview of all currently available therapeutic strategies in sarcoidosis. In addition, the gaps in current literature on sarcoidosis treatment were depicted to underline the importance of research in this mostly empiric field of medicine. Furthermore we highlight future medicine in sarcoidosis with emphasis on the role of personalised medicine.
结节病是一种可累及多个器官的全身性肉芽肿性疾病，临床病程多变。自20世纪50年代首次用于治疗结节病以来，皮质类固醇（如泼尼松）一直是其主要治疗药物。如果出现无法耐受的副作用、治疗无效或长期使用类固醇，通常会在治疗方案中添加二线治疗药物。许多人认为甲氨蝶呤是结节病二线治疗的首选药物。其他常用的二线药物有硫唑嘌呤和来氟米特。尚未在结节病患者中进行比较不同治疗方案的大型试验。对于对一线和二线治疗反应不佳的重症患者，英夫利昔单抗等生物制剂可能很有前景。在本综述中，我们全面概述了目前结节病所有可用的治疗策略。此外，还描述了当前结节病治疗文献中的空白，以强调在这个大多基于经验的医学领域进行研究的重要性。此外，我们重点介绍了结节病的未来医学，强调了个性化医疗的作用。
