The place of systemic corticosteroids and methotrexate in the treatment of sarcoidosis: discussion of a new position

Le résumé fourni par la source

Sarcoidosis is a chronic inflammatory disease characterized by the formation of granulomas in various organs and body systems. It manifests with a variety of symptoms, involving lungs, joints, skin, eyes, and other organs. The aim of this review was to discuss a new approach to long-term sarcoidosis therapy. Results . Treatment of sarcoidosis includes various approaches aimed at suppressing inflammation and granulomatosis progression, and preventing complications such as organ and system failure and fibrosis, but each approach is advisory in nature. For over half a century, corticosteroids have remained the standard first-line treatment, but their long-term use is associated with serious side effects. Methotrexate and other immunosuppressants offer alternatives to corticosteroids and are used when the latter are ineffective or intolerable. However, the choice of drug is personalized. Long-term glucocorticoid use is associated with an increased risk of developing diabetes, hypertension, osteoporosis, and infections. Therefore, it is important to monitor side effects and promptly adjust treatment strategies. Conclusion . The current position suggests switching to methotrexate after initial hormonal therapy, which provides long-term disease control with fewer side effects.

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