Effective treatment of sarcoidosis: A Synthesis of Findings from 10 Studies

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Original Abstract of the Article

Main Research Findings

Many studies have been conducted on the effectiveness of treatments for fatigue and pulmonary sarcoidosis. 8 found that anti-tumor necrosis factor (TNF)-α therapies (adalimumab and infliximab) and neurostimulants (methylphenidate and armodafinil) may be effective treatments for fatigue associated with sarcoidosis. However, five of these studies had a high risk of bias, and the remaining three studies involved a small number of participants and had short durations. Further research is needed to confirm these findings.

9 is a feasibility study that explored the use of methylphenidate for fatigue in patients with sarcoidosis. The study found that methylphenidate is a promising treatment option, although more research is needed before it can be recommended for clinical practice.

4 investigated the effects of oral and inhaled corticosteroids on pulmonary sarcoidosis. This study showed that oral corticosteroids may be effective in reducing symptoms and minimizing long-term damage in pulmonary sarcoidosis. However, the effects of inhaled corticosteroids are inconclusive due to small study sizes and inconsistent results.

5 examined the efficacy of immunosuppressants and cytotoxic agents in treating pulmonary sarcoidosis. While these treatments showed potential as alternatives or maintenance therapy for oral corticosteroids, they can have severe side effects.

10 conducted a randomized controlled trial to investigate the effects of bosentan on steroid-resistant pulmonary sarcoidosis. No evidence was found to support bosentan as an effective treatment for steroid-resistant pulmonary sarcoidosis, however, bosentan was well-tolerated by participants.

Treatment Summary

8 found that anti-tumor necrosis factor (TNF)-α therapies (adalimumab and infliximab) and neurostimulants (methylphenidate and armodafinil) may be effective treatments for fatigue associated with sarcoidosis. 9 suggests that methylphenidate is a promising treatment option for fatigue in patients with sarcoidosis. 4 indicates that oral corticosteroids are effective for reducing symptoms and minimizing long-term damage in pulmonary sarcoidosis. However, the effects of inhaled corticosteroids are inconclusive. 5 found that immunosuppressants and cytotoxic agents show potential as alternative treatments or for maintaining low doses of corticosteroids, but they can have severe side effects. 10 found no evidence supporting bosentan as an effective treatment for steroid-resistant pulmonary sarcoidosis, although the drug was well-tolerated.

Benefits and Risks

Benefit Summary

Anti-tumor necrosis factor (TNF)-α therapies (adalimumab and infliximab) and neurostimulants (methylphenidate and armodafinil) may be effective treatments for fatigue associated with sarcoidosis. 8 Methylphenidate is a promising treatment option for fatigue in patients with sarcoidosis. 9 Oral corticosteroids are effective for reducing symptoms and minimizing long-term damage in pulmonary sarcoidosis. 4

Risk Summary

Immunosuppressants and cytotoxic agents, while potentially effective as alternatives or for maintaining low doses of corticosteroids, can have severe side effects. 5 Bosentan, while well-tolerated, did not demonstrate effectiveness as a treatment for steroid-resistant pulmonary sarcoidosis. 10

Study Comparisons

Study Commonalities

These studies all aimed to investigate the effectiveness of various treatments for fatigue and pulmonary sarcoidosis. In addition to the effects of the treatments, the studies also assessed their safety.

Study Differences

The studies differed in their specific focus on various diseases, treatments, study designs, number of participants, and duration of the studies. Therefore, it may be difficult to directly compare the findings of these studies.

Consistency and Inconsistencies of Results

The results of studies investigating treatments for fatigue associated with sarcoidosis show some consistency, indicating that anti-TNF-α therapies and neurostimulants may be effective. However, these findings require confirmation due to limitations in the studies, including small sample sizes and short durations. Oral corticosteroids have consistently shown efficacy in treating pulmonary sarcoidosis. However, the effects of inhaled corticosteroids are inconclusive, warranting further research. While immunosuppressants and cytotoxic agents may be effective alternatives or for maintaining low doses of corticosteroids, they can have severe side effects. No evidence supports bosentan as an effective treatment for steroid-resistant pulmonary sarcoidosis, although the drug was well-tolerated.

Applying Findings to Daily Life

It's important to consult a doctor to determine the most appropriate treatment for fatigue and pulmonary sarcoidosis based on individual symptoms and conditions. Avoid self-treating or stopping treatment without consulting a doctor.

Limitations of Current Research

There are limitations in current research on treatments for fatigue and pulmonary sarcoidosis, including small sample sizes and short durations. This highlights the need for further research.

Future Research Directions

Large-scale clinical trials are essential to develop more effective treatments for fatigue and pulmonary sarcoidosis. Further research is also needed to assess the long-term effects and side effects of existing treatments.

Conclusion

While extensive research has been conducted on treatments for fatigue and pulmonary sarcoidosis, more evidence is required. Further studies are essential to develop more effective treatments. If you are experiencing fatigue or pulmonary sarcoidosis, consult a doctor.

Treatment List

Anti-TNF-α therapies, neurostimulants, oral corticosteroids, inhaled corticosteroids, immunosuppressants, cytotoxic agents, bosentan, exercise programs, ARA 290

Literature analysis of 10 papers
Positive Content
4
Neutral Content
4
Negative Content
2
Article Type
3
1
7
7
10
1.

Corticosteroid therapy of pulmonary sarcoidosis. A prospective evaluation of alternate day and daily dosage in stage II disease.

Author: SelroosO, SellergrenT L

Effective sarcoidosis treatment
Improved lung function

A study of 39 patients with sarcoidosis compared the effects of 7 months of methylprednisolone treatment to observation without treatment. Patients receiving methylprednisolone (either daily or alternate-day) had better lung function and chest x-ray results after 7 months. However, after 24 and 48 months, there were no significant differences in outcomes between the treated and untreated groups. This suggests that corticosteroid treatment for sarcoidosis may provide short-term benefits but does not alter long-term outcomes.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Corticosteroids for pulmonary sarcoidosis.

Author: ParamothayanN S, JonesP W

Improved understanding of pulmonary sarcoidosis treatment

Pulmonary sarcoidosis is a common condition with an unpredictable course. While corticosteroids (oral or inhaled) are often used to treat it, there is no agreement on when, how much, or how long to use them. Since long-term corticosteroid use can have negative side effects, researchers are investigating whether these medications provide any lasting benefit for pulmonary sarcoidosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

Corticosteroids for pulmonary sarcoidosis.

Author: ParamothayanN S, JonesP W

Deleterious side effects of steroids
Unclear benefit of corticosteroids
Unpredictable course

Pulmonary sarcoidosis is a common condition with unpredictable outcomes. While corticosteroids are often used to treat it, doctors don't agree on when, how much, or for how long they should be used. Since long-term use of corticosteroids can have serious side effects, it's important to know if they provide any lasting benefits for pulmonary sarcoidosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Corticosteroid therapy in pulmonary sarcoidosis: a systematic review.

Author: ParamothayanShanthi, JonesPaul W

Chest radiograph improvement
Diffusing capacity improvement
Vital capacity improvement

Oral corticosteroids improved chest radiograph results and lung function in patients with stage 2 and 3 pulmonary sarcoidosis. There were no data to suggest that corticosteroid therapy alters long-term disease progression.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

5.

Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis.

Author: ParamothayanS, LassersonT, WaltersE H

Steroid sparing effect
Severe side effects

The current body of evidence supporting the use of immunosuppressive agents and cytotoxic therapies in pulmonary sarcoidosis is limited, with severe side-effects associated with some therapies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Corticosteroids for pulmonary sarcoidosis.

Author: ParamothayanN S, LassersonT J, JonesP W

Deleterious side-effects
Unclear benefit

Pulmonary sarcoidosis is a common lung condition with unpredictable outcomes. While oral or inhaled corticosteroids are widely used, there's no agreement on when or for whom treatment should start, or what dose and duration is best. Corticosteroids can have serious side effects when taken for long periods, so it's important to know if they provide lasting benefits for pulmonary sarcoidosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

7.

Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis.

Author: ParamothayanS, LassersonT J, WaltersE H

Steroid sparing effect
Severe side effects

There is limited evidence to support the use of immunosuppressive agents and cytotoxic therapies for pulmonary sarcoidosis. Side effects associated with some of these therapies were severe.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

Managing fatigue in sarcoidosis - A systematic review of the evidence.

Author: AtkinsChris, WilsonAndrew M

Fatigue improvement
TNF-α therapy benefit
High risk of bias
Limited evidence

This review assessed treatment options for sarcoidosis-associated fatigue, finding some evidence to support the use of anti-TNF-α therapies and neurostimulants.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

9.

Feasibility study of a randomised controlled trial to investigate the treatment of sarcoidosis-associated fatigue with methylphenidate (FaST-MP): a study protocol.

Author: AtkinsChristopher, FordhamRichard, ClarkAllan B, StocklAndrea, JonesAndrew P, WilsonAndrew M

Reduced fatigue

Methylphenidate, a neurostimulant, is a potential treatment option for fatigue in chronic sarcoidosis, but requires further evaluation before clinical recommendation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Bosentan for patients with steroid-resistant pulmonary sarcoidosis: a randomised controlled trial.

Author: HostettlerKatrin, BatyFlorent, KleinerRebekka, JunkerLilian, TammMichael, BrutscheMartin

This study assessed the efficacy and safety of bosentan in patients with steroid-resistant sarcoidosis. In a 12-month, double-blind, placebo-controlled phase II trial, there were no statistically significant differences observed in the primary endpoints, including total lung capacity, diffusion capacity, 6-minute walking distance, peak oxygen uptake, and computed tomography-score. Bosentan was well tolerated and no drug-related adverse effects were observed.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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