11th January 2024

Sarcoidosis

About half of patients with sarcoidosis require treatment, which depends on stage of the condition.

• Asymptomatic, stage 1: usually only observation is required
• Symptomatic, stage 1: oral corticosteroids. Consider gastric protection and osteoporosis prophylaxis if steroids are used long-term. However, vitamin D and calcium supplementation are often avoided due to risk of hypercalcaemia in sarcoidosis
• Symptomatic, stage 2 and above: oral corticosteroids are a mainstay of treatment. Cytotoxic medications such as methotrexate or azathioprine may be considered, but this should always be discussed with a respiratory consultant. If symptoms persist, or there is evidence of progression, biological therapies can also be given, e.g. infliximab.
• Lung transplantation