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Treatments and drugs
By Mayo Clinic staffYou may not need treatment for sarcoidosis if you don't have any signs and symptoms or if they aren't bothering you. Because sarcoidosis often disappears on its own at this stage, your doctor is likely just to monitor you closely.
When chest X-rays reveal more widespread areas of lung inflammation, your doctor may monitor the disease for three to 12 months and begin treatment if the inflammation hasn't improved or has progressed.
On the other hand, treatment with medications is usually recommended if your heart, eyes, kidneys or central nervous system is involved, as related complications can be serious.
Corticosteroid treatment
Doctors generally use the corticosteroid drug prednisone to treat sarcoidosis. Corticosteroids are powerful anti-inflammatory drugs that mimic the effects of hormones produced by your adrenal glands. They're not the same as the anabolic steroids used by some athletes to increase strength and muscle mass.
Just how long to continue prednisone is a matter of debate. In some cases, you may take medication for several years, using as low a dose as possible while still controlling the disease. For a small percentage of people, symptoms return when the medication is discontinued. In addition, prednisone can cause serious side effects, especially when it's taken long term. These side effects include:
- Osteoporosis, a disease that causes your bones to become thin and brittle, leading to fractures
- High blood pressure
- Cataracts
- Diabetes
- Increased risk of infection
- Weight gain and redistribution of body fat
Talk to your doctor about the best ways to help prevent or reduce the possibility of side effects. One option is to take prednisone every other day, rather than every day.
Other drugs
If you aren't able to tolerate steroid treatment, your doctor may recommend treatment with drugs that help reduce inflammation by suppressing your immune system. Options may include methotrexate or azathioprine (Imuran). But these drugs are powerful, as well, and carry their own risks, such as making you more vulnerable to infections.
The antimalarial drug, hydroxychloroquine (Plaquenil), may be helpful for skin disease, nervous system involvement and elevated blood-calcium levels.
Your doctor can help you decide on the best sarcoidosis treatment. This usually involves weighing the risks and benefits of medications such as corticosteroids and immunosuppressants against the discomfort and risks of leaving the disease untreated.
