Treatment of Sarcoidosis

Currently, there is no cure for sarcoidosis. In many cases, the disease improves gradually on its own over time. Signs and symptoms of sarcoidosis may vary from mild to severe. People with mild symptoms, do not require any treatment. Treatment is needed when the symptoms are bothersome. Treatment of sarcoidosis includes:

• Maintenance of good health practices and
• Drug treatment.

Good health practices: Some of the recommended good health practices include:

• Regular follow-up with your health care provider.
• Eating healthy and well-balanced diet (which includes a variety of fresh fruits and vegetables and whole grain food products).
• Drinking plenty of water daily (about 8 to 10 8-ounce glasses of water).
• Healthy sleeping habits (getting about 6 to 8 hours of sleep each night).
• Doing exercises regularly.
• Maintaining healthy body weight.
• Quitting smoking.
• Limiting exposure to substances that can harm your lungs such as dust, chemicals, fumes, gases, toxic inhalants etc.

Medications: Medications are given to control symptoms, control inflammation of the affected tissues, reduce the impact of granuloma development and prevent lung fibrosis and other irreversible organ damage.

Corticosteroids: They form the first line of drugs used in the management of sarcoidosis. Owing to their anti-inflammatory activities, they are very effective in reducing inflammation. Prednisolone, an oral corticosteroid, is the most commonly used corticosteroid. Some of the common side effects associated with long term steroid therapy include excessive weight gain, insomnia, acne, diabetes in susceptible people, high blood pressure, glaucoma, cataracts, osteoporosis, depression and emotional irritability, skin bruising, increased risk of infections etc. Owing to their side effects, corticosteroid therapy is usually not recommended for patients with no symptoms or very mild symptoms. Corticosteroids are usually recommended for patients with moderate to severe disease. Symptoms such as cough and shortness of breath improve considerably with steroid therapy. Corticosteroid treatment, however, controls the disease and does not cure it.

Alternative treatments to corticosteroids: Other treatment options may be considered for patients, who cannot tolerate steroids, because side effects cannot be tolerated or it is contraindicated or if there is no response. Some of the alternative treatments to corticosteroids include:

• Methotrexate or azathioprine.
• Hydroxychloroquine and chloroquine (these are basically oral antimalarial drugs).
• Cyclophosphamide or chlorambucil (usually reserved for patients with severe disease and after other therapies have failed).
• Pentoxifylline and thalidomide.
• Infliximab or adalimumab.
• Colchicine.
• NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen or aspirin.
• Topical corticosteroids.
• Organ transplantation (rarely done; is considered in patients with end-stage disease where the kidneys or lungs have failed).

These therapies, however, have not been studied much extensively than corticosteroids in people with sarcoidosis. Experts say that doctors with special expertise in the management of sarcoidosis should manage patients, who are on a regular prednisone therapy or any of the alternative therapies.