Up to one half of the people diagnosed with sarcoidosis improve without treatment. Those who do not improve are often placed on medicine to reduce inflammation. Many people will recover, but some will get worse despite treatment.
The goals of treatment are to:
- Maintain good organ function
- Lessen symptoms
- Prevent organ damage
Several medicines are used to treat sarcoidosis.
Corticosteroids: Corticosteroids, which work to reduce inflammation, are the main treatment. Generally, prednisone (a tablet) is given daily or every other day, depending on the symptoms. Prednisone can decrease symptoms, improve lung function, reduce granuloma formation, and possibly lessen scarring of the lungs. Prednisone can be associated with a number of side effects. Because of this, a doctor should carefully monitor people on corticosteroids. Prednisone is not the drug of choice for long-term management of sarcoidosis.
Methotrexate: For long-term management of sarcoidosis, steroid-sparing agents are typically used. Methotrexate is an anti-inflammatory medicine and is often used as a second-line medicine. It may be used with corticosteroids or after stopping corticosteroids.
Other Medicines: Other medicines are used if corticosteroids and methotrexate are not effective. These other medicines are not used often, since their effect on sarcoidosis is not as well understood. They also can have side effects. These medicines include azathioprine, hydroxychloroquine, mycophenolate mofetil and remicade.
Oxygen Therapy: Oxygen therapy may be an important part of a treatment plan for people with severe sarcoidosis. It can help reduce heart and lung side effects of low oxygen levels.
Pulmonary Rehabilitation: For people who develop chronic, progressive sarcoidosis, pulmonary rehabilitation also may be helpful.
Because treatment is so important, a person can improve the outcome of sarcoidosis by seeing a doctor when the symptoms first appear. This can help prevent damage to the lungs, eyes, heart, and other organs. Also, people with sarcoidosis should continue to follow up with their doctor after they have been diagnosed to monitor if the disease is progressing.