Sarcoidosis Association
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Treatment and Medication


There is no cure for this disease only treatment.  No surgery can be taken to make it disappear as the Granulomas build over scar tissue and will make the patient even worse.

Treatment depends on how severe the disease is and what stage it is at.  To find out, you need to have a proper diagnosis by having several tests.  These test include a chest X-ray, Blood Tests, a Physical examination and breathing tests.

There are a number of medications used to treat Sarcoidosis. Steroids is the most commonly used by the medical profession, to suppress the immune system which makes it more likely for the patient to become ill from infection. The risks of steroid use should be clearly detailed to you, including its side effects of long term use, for your consideration prior to accepting this treatment.

Different treatments will work better on some people than othersThis is why sometimes two types of treatment are used.  In some cases treatment is not needed (e.g. acute Sarcoidosis).

It is important to recognise that treatment and management is required for both the Sarcoidosis and symptoms reducing the quality of life as two issues. For example it is to be understood that although immune suppressants may be given they will not necessarily reduce the symptoms you are suffering.

For some patients intense treatment is needed especially when several organs are affected.

Medication

There is numerous types of medication for Sarcoidosis these are as follows with descriptions.

Corticosteroid:

This is considered the first line of treatment for Sarcoidosis that requires treatment.  Corticosteroids are also called steroids and there are many different medicines within the corticosteroid class of drugs, including Cortisone, Prednisolone, and Prednisolone.  These powerful drugs effectively reduce inflammation throughout the body in most people, thereby slowing, stopping, or even preventing the organ damage that Sarcoidosis can cause.

These can be taken alone or in combination with other Sarcoidosis medicines.  Neither the dose used or the duration are standardised.  Most doctors will prescribe a moderate to high dosage of corticosteroids initially, but they will try to reduce the dosage gradually as symptoms are brought under control because high dosages of corticosteroids and/or long-term treatment can cause serious side effects.

The side effects include mood swings, weight gain, acne, difficulty sleeping at night, and when taken for a long time problems such as osteoporosis, diabetes, high blood pressure, cataracts, glaucoma and other serious conditions.  People with chronic Sarcoidosis will need ongoing corticosteroid therapy for a long time, possibly a lifetime, so the lowest dosage that still suppresses inflammation is desirable.

Methotrexate:

It has been an effective treatment for some people with Sarcoidosis.  It acts by inhibiting the metabolism of folic acid. Methotrexate replaced the more powerful and toxic antifolate aminopterin, and the two should not be confused with each other.

The side affects of this treatment is that it can cause nausea, mouth sores, and/or hair loss, and, because it weakens your immune system, it can also increase your risk of getting infections.  Rarely, methotrexate causes an allergic reaction in the lungs, but that reaction stops when you stop taking the drug.  The most serious potential side effect of methotrexate is liver damage.  You can have your Doctor do liver function tests to see if any damage has been done.

Hydroxychloroquine

Used to treat malaria in most cases. As a treatment for Sarcoidosis, these drugs are most likely to be effective in people who have skin symptoms and a high level of calcium in their blood.

The side affects are that it can irritate the stomach.  They can also cause severe eye problems.  When taking this medication you should have your eyes checked every 3 months.

Mycophenolate mofetil

Today, doctors often prescribe it to treat a number of autoimmune and inflammatory diseases including rheumatoid arthritis and lupus nephritis.  Several very small studies have shown it to be effective in treating Sarcoidosis.

Side effects can include sore throat, fever, tiredness, tingling or burning in one part of the body and weakness.

Azathioprine

This is most commonly used to treat inflammatory diseases such as rheumatoid arthritis and inflammatory bowel disease.  What little research has been done on the subject shows that azathioprine is roughly as effective as methotrexate in treating Sarcoidosis.

The side effects of azathioprine include upset stomach, stomach pain, mouth sores, muscle aches, flu-like symptoms, yellowing of the skin or eyes and blurred vision.

Cyclophosphamide

This is sometimes prescribed for Sarcoidosis.  It is more toxic than either methotrexate or azathioprine however, so most doctors only prescribe it when other medications have not worked and a person’s symptoms are very serious.  Preliminary and case studies have shown that cyclophosphamide appears to be effective for some people and is perhaps particularly useful in cases where brain and nervous system symptoms have not responded to other treatments.

Its side effects can include nausea, weight loss, hair loss, acne, darkened and thickened skin, mouth blisters, and fatigue.

Potential Treatments

A number of new and old medication treatment which has not been tested yet looks promising for Sarcoidosis patients as it targets parts of the immune system.  These drugs are as follows:

Infliximab

Used to treat inflammation of the bowel, it has been used for other inflammation diseases and researchers have found it to help with the Sarcoidosis.  More research on the medication is needed.

 

 

Copyright © 2013 Martine Caitlan of the Sarcoidosis Association. Registration Number 330053. All rights reserved.