What noncorticosteroid agents are used in the treatment of sarcoidosis?

Updated: Sep 15, 2020
  • Author: Nader Kamangar, MD, FACP, FCCP, FCCM; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Noncorticosteroid agents include the following:

  • Methotrexate (MTX) has been a successful alternative to prednisone

  • Chloroquine and hydroxychloroquine have been used for cutaneous lesions, hypercalcemia, neurologic sarcoidosis, and bone lesions

  • Chloroquine has been found effective for acute and maintenance treatment of chronic pulmonary sarcoidosis [3, 4]

  • Cyclophosphamide has been rarely used with modest success as a steroid-sparing treatment in patients with refractory sarcoidosis [5, 6]

  • Azathioprine is best used as a steroid-sparing agent [7]

  • Chlorambucil may be beneficial in patients with progressive disease unresponsive to corticosteroids or when corticosteroids are contraindicated [8]

  • Cyclosporine may be of limited benefit in skin sarcoidosis or in progressive sarcoid resistant to conventional therapy [9]

  • Infliximab [10, 11] and thalidomide [12, 13] have been used for refractory sarcoidosis, particularly for cutaneous disease, as well as for the long-term management of extrapulmonary sarcoidosis [14]

  • Infliximab appears to be an effective treatment for patients with systemic manifestations such as lupus pernio, uveitis, hepatic sarcoidosis, and neurosarcoidosis


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