Servei de Pneumologia, Respiratory Institute, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
Centro de Investigación Biomedica en Red-Enfermedades Respiratorias (CibeRes, CB06/06/0028), Barcelona, Spain.
Curr Opin Pulm Med. 2020 Sep;26(5):591-597. doi: 10.1097/MCP.0000000000000720.
Sarcoidosis is a granulomatous systemic disease of unknown cause where the lung is the most frequently affected organ. Therapeutic management of the disease is challenging as clinical presentation and prognosis are very heterogeneous. In the present review, we will summarize the main advances in sarcoidosis therapy.
Current sarcoidosis therapies are categorized in three lines: glucocorticoids (first line), immunosuppressants (second line), and biologics (third line). Recent glucocorticoid studies have reported that efficacy could be similar with high and low doses, but with an increase in side effects with higher doses. In immunosuppressants, recent publications in mycophenolate and repository corticotropin injection (RCI) have added more information in their use and efficacy. Finally, new evidence has been published in the use of antitumor necrosis factor (anti-TNFα) agents in refractory cardiac sarcoidosis and neurosarcoidosis.
Sarcoidosis therapy is constantly evolving, and new drugs have been added to the recommended treatments. However, extensive clinical trials are still necessary to optimize the current recommendations.
结节病是一种病因不明的肉芽肿性全身性疾病，肺部是最常受影响的器官。由于临床表现和预后差异很大，因此该疾病的治疗极具挑战性。在本综述中，我们将总结结节病治疗的主要进展。
目前的结节病治疗方法分为三线：糖皮质激素（一线）、免疫抑制剂（二线）和生物制剂（三线）。最近的糖皮质激素研究表明，高剂量和低剂量的疗效可能相似，但高剂量会增加副作用。在免疫抑制剂方面，最近关于霉酚酸酯和皮质激素贮存剂注射（RCI）的出版物增加了其使用和疗效的更多信息。最后，在难治性心脏结节病和神经结节病中使用抗肿瘤坏死因子（抗 TNFα）药物的新证据已经发表。
结节病的治疗方法不断发展，新的药物已被添加到推荐的治疗方案中。然而，仍需要进行广泛的临床试验来优化当前的建议。
