P161 Steroids for sarcoidosis- do they really work?. (December 2018)

• Record Type: Journal Article
• Authors: Dorrian, D; Minnis, P; Donnelly, SC
• Is Part Of: Thorax. Volume 73(2018)Supplement 4
• Page Start: A189
• Page End: A190
• Publication Date: 2018-12
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax-2018-212555.319
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Aims and objectives: Corticosteroids remain the mainstay of therapy in sarcoidosis. At present despite extensive use there is limited evidence of long term survival benefit. 1 We aimed to interrogate a large cohort of patients diagnosed with sarcoidosis in order to identify measures of active disease, predictors for progression and response to standard treatment; particularly with regard to physiological measures. Methods: Clinical data from 325 patients with sarcoidosis was recorded retrospectively including; age at diagnosis, gender, Scadding CXR stage at presentation, presence of Erythema Nodosum (EN), baseline inflammatory markers, immunoglobulin levels, liver function, and pulmonary function. There was a minimum follow up of 2 years for all patients. Data was available for subgroups at 5 and 10 years. The primary outcome measure was the physiological response to treatment prescribed by a single physician based on ATS/ERS/WASOG criteria. Treatment was defined as requiring oral corticosteroids for 6 months or more. Results: Patients were characterised into four groups dependent on scadding stage. Co-variate analysis based on the clinical need for treatment and presence of abnormal pulmonary function at diagnosis was performed. Overall the treatment rate was 50.1% in this cohort. Initial investigation documented patients treated with steroids had a smaller average percentage change in FVC at 2 years compared with those not treated when corrected for other variables. Treatment group mean=11.78%, Un-treated group 25.44%, p=0.0056. Treatment with steroids was not shown to have a statistically significant effect on rate of change of transfer factor when corrected for other co-variables. Conclusion: This study has documented benefit in the use of steroids to prevent decline in FVC over a 2 year period. Further work in terms of persistent of disease activity from peripheral biomarkers is ongoing and may shed further insight in predicting fibrotic phenotypes. Reference: JC Grutters, et al. Corticosteroid treatment in sarcoidosis. ERJ2006;28:627–36.