Gender differences disparity in treatments for in Sarcoidosis from the British Thoracic Society (BTS) UK Interstitial Lung Disease (ILD) registry.

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Introduction: Sarcoidosis is a multisystem inflammatory disease that can vary by gender in presentation, associated conditions, and outcomes. Understanding these differences is essential for better management. Objectives: The aims were to assess if there were any gender disparities in the presentation and outcomes for patients presenting with Sarcoidosis in the UK. Methods: Data from the BTS UK ILD registry (2013–2024) were analyzed. Demographic profiles, symptoms, comorbidities, pulmonary function, and treatment patterns were compared between males and females with informed consent. Statistical tests were Chi-squared, T-Test, and U-Mann Whitney. Results: Among 993 patients with sarcoidosis (60% male), females were older (56 [46-63] vs 52 [42-61] years, p=0.002), less often current/ex-smokers (35.4% vs. 64.6%, p=0.019), and had shorter symptom duration (<6 months: 60% vs 40%, p=0.038). Comorbidities were similar, except arrhythmia was more frequent in males (100% vs 0%, p=0.040) and prior tuberculosis in females (87.5% vs. 12.5%, p=0.007). Elevated ESR was more common in females (65.6% vs 34.4%, p=0.003), while raised ACE (32% vs 68%, p=0.050) and lymphopenia (32% vs 68%, p=0.003) were more frequent in males. Baseline lung function was similar. First-line prednisolone use was similar, but males received methotrexate (76% vs 24%, p=0.017) and overall pharmacotherapy (60% vs 40%) more often. Conclusion: Despite similar lung function and presentations, females received less treatment. These disparities warrant further investigation to assess their impact on long-term outcomes in females compared to males and to improve gender-specific management

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