ERS clinical practice guidelines on treatment of sarcoidosis
Por:
Baughman, RP, Valeyre, D, Korsten, P, Mathioudakis, AG, Wuyts, WA, Wells, A, Rottoli, P, Nunes, H, Lower, EE, Judson, MA, Israel-Biet, D, Grutters, JC, Drent, M, Culver, DA, Bonella, F, Antoniou, K, Martone, F, Quadder, B, Spitzer, G, Nagavci, B, Tonia, T, Rigau, D, Ouellette, DR
Publicada:
1 dic 2021
Resumen:
Background The major reasons to treat sarcoidosis are to lower the morbidity and mortality risk or to improve quality of life (QoL). The indication for treatment varies depending on which manifestation is the cause of symptoms: lungs, heart, brain, skin or other manifestations. While glucocorticoids remain the first choice for initial treatment of symptomatic disease, prolonged use is associated with significant toxicity. Glucocorticoid-sparing alternatives are available. The presented treatment guidelines aim to provide guidance to physicians treating the very heterogenous sarcoidosis manifestations. Methods A European Respiratory Society Task Force committee composed of clinicians, methodologists and patients with experience in sarcoidosis developed recommendations based on the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology. The committee developed eight PICO (Patients, Intervention, Comparison, Outcomes) questions and these were used to make specific evidence-based recommendations. Results The Task Force committee delivered 12 recommendations for seven PICOs. These included treatment of pulmonary, cutaneous, cardiac and neurologic disease as well as fatigue. One PICO question regarding small-fibre neuropathy had insufficient evidence to support a recommendation. In addition to the recommendations, the committee provided information on how they use alternative treatments, when there was insufficient evidence to support a recommendation. Conclusions There are many treatments available to treat sarcoidosis. Given the diverse nature of the disease, treatment decisions require an assessment of organ involvement, risk for significant morbidity, and impact on QoL of the disease and treatment.
Filiaciones:
Baughman, RP:
Univ Cincinnati, Med Ctr, Dept Med, Cincinnati, OH 45267 USA
Valeyre, D:
Univ Sorbonne Paris Nord, Hop Avicenne, AP HP, INSERM UMR 1272, Bobigny, France
Grp Hosp Paris St Joseph, Paris, France
Korsten, P:
Univ Med Ctr Gottingen, Dept Nephrol & Rheumatol, Gottingen, Germany
Mathioudakis, AG:
Manchester Univ NHS Fdn Trust, Wythenshawe Hosp, North West Lung Ctr, Manchester, Lancs, England
Univ Manchester, Div Infect Immun & Resp Med, Manchester, Lancs, England
Wuyts, WA:
Univ Hosp Leuven, Dept Resp Med, Unit Interstitial Lung Dis, Leuven, Belgium
Wells, A:
Royal Brompton Hosp, London, England
Rottoli, P:
Siena Univ, Dept Med Surg & Neurol Sci, Specializat Sch Resp Dis, Siena, Italy
Nunes, H:
Univ Sorbonne Paris Nord, Hop Avicenne, AP HP,INSERM UMR 1272, Serv Pneumol,Ctr Reference Malad Pulmonaires Rare, Bobigny, France
Lower, EE:
Univ Cincinnati, Med Ctr, Dept Med, Cincinnati, OH 45267 USA
Judson, MA:
Albany Med Coll, Dept Med, Albany, NY 12208 USA
Israel-Biet, D:
Univ Paris, Hop Europeen Georges Pompidou, AP HP, Ctr Competences Malad Rares Pulmonaires, Paris, France
Grutters, JC:
St Antonius Hosp, Dept Pulmonol, ILD Ctr Excellence, Nieuwegein, Netherlands
Univ Med Ctr Utrecht, Div Heart & Lungs, Utrecht, Netherlands
Drent, M:
St Antonius Hosp, Dept Pulmonol, ILD Ctr Excellence, Nieuwegein, Netherlands
Maastricht Univ, Fac Hlth & Life Sci, Dept Pharmacol & Toxicol, Maastricht, Netherlands
ILD Care Fdn Res Team, Ede, Netherlands
Culver, DA:
Cleveland Clin, Cleveland, OH 44106 USA
Bonella, F:
Univ Essen Gesamthsch, Univ Hosp, Ruhrlandklin, Ctr Interstitial & Rare Lung Dis,Pneumol Dept, Essen, Germany
Antoniou, K:
Univ Crete, Med Sch, Lab Mol & Cellular Pneumonol, Dept Resp Med, Iraklion, Greece
Martone, F:
Amici Contro Sarcoidosi Italia ONLUS, Bologna, Italy
Quadder, B:
Deutsch Sarkoidose Vereinigung eV DSV, Meerbusch, Germany
Spitzer, G:
Fdn Sarcoidosis Res, Chicago, IL USA
Nagavci, B:
Univ Freiburg, Med Ctr, Inst Evidence Med, Freiburg, Germany
Univ Freiburg, Fac Med, Freiburg, Germany
Tonia, T:
Univ Bern, Inst Social & Prevent Med, Bern, Switzerland
Rigau, D:
Cochrane Iberoamer, Barcelona, Spain
Ouellette, DR:
Henry Ford Hosp, Detroit, MI 48202 USA
Bronze, Green Accepted
|