Pulmonology Department, Hospital Clínic, WASOG Centre of Excellence, Respiratory Institute, Barcelona, Spain.
Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Expert Opin Pharmacother. 2024 Jul;25(10):1317-1324. doi: 10.1080/14656566.2024.2377714. Epub 2024 Jul 11.
Sarcoidosis is a chronic granulomatous of unknown etiology that mostly affects lungs with an heterogenous clinical presentation and prognosis. Therefore, therapeutic management of the disease is challenging. The goals of treatment are to prevent or to minimize organ damage, to relieve symptoms, and to improve the patient's quality of life.
The present review covers current pharmacotherapy options for pulmonary sarcoidosis. Corticosteroids are still the first-line treatment option, however, for those patients with prolonged expectation of treatment, undesirable side effects and refractory disease, immunosuppressive drugs are preferred options. Biological drugs are promising third line therapies. Recent evidence shows that antifibrotic agents, such as nintedanib, have a role in fibrotic lung disease, as well as efzofitimob, which has shown promising results in controlling inflammatory lung disease.
Sarcoidosis treatment is evolving as new molecules are available. The number of studies of therapies for pulmonary sarcoidosis has increased in recent years, however, the information available is still limited and there is no consensus on how to monitor the activity of the disease.
结节病是一种病因不明的慢性肉芽肿性疾病,主要影响肺部,临床表现和预后存在异质性。因此,该病的治疗具有挑战性。治疗的目的是预防或最小化器官损伤、缓解症状和提高患者的生活质量。
本文综述了目前用于治疗肺结节病的药物选择。皮质类固醇仍然是一线治疗选择,然而,对于那些需要长期治疗、存在不可接受的副作用和难治性疾病的患者,免疫抑制剂是首选。生物药物是很有前途的三线治疗方法。最近的证据表明,抗纤维化药物,如尼达尼布,在纤维化性肺部疾病中有作用,efzofitimob 也在控制炎症性肺部疾病方面显示出良好的效果。
随着新分子的出现,结节病的治疗方法正在不断发展。近年来,针对肺结节病治疗的研究数量有所增加,但可用的信息仍然有限,而且对于如何监测疾病的活动还没有共识。