Corticosteroid therapy of intrathoracic sarcoidosis stages I and II--results of a controlled clinical trial.

It is difficult to evaluate the efficacy of sarcoidosis therapy. There are high rates of spontaneous remission, frequently pushing course and tendency to relapses after treatment. 280 patients with histologically confirmed mediastino-pulmonary sarcoidosis in stage I and II without extrapulmonary manifestations have been admitted until now in a controlled clinical trial. More than 150 of them have been analysed after a follow-up of 3 to 5 years, in 40 cases already to 7 years. The patients have been treated by prednisolone and isoniazide for six and 12 months respectively and compared with a non-treated control group. 6 and 12 months after the start of observation X-ray regression has been more often observed in the treated than in the non-treated patients. However, the results after 3 and 5 years were nearly similar in all groups: improvement in 75% and complete resolution in 60% respectively. It seems to us therefore that prednisolone shows only an effect on the early stage of sarcoidosis but is without any influence on the late X-ray results. In consequence corticosteroid therapy is clearly indicated only in patients with progressive course of the disease.