Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis

There is insufficient evidence on the effects of immunosuppressive agents and cytotoxic therapies in the treatment of pulmonary sarcoidosis.

A Cochrane review included 5 studies with a total of 164 subjects. The trials compared either methotrexate, chloroquine, cyclosporin A or pentoxifylline with placebo or oral prednisone. No data could be combined for a meta-analysis. Data on lung function, chest x-ray scores and dyspnoea were largely inconclusive. Adverse effects were associated with methotrexate, cyclosporin A, chloroquine and pentoxifylline. In two small studies methotrexate and pentoxifylline were associated with a steroid sparing effect. In the methotrexate study this was apparent after 12 months of therapy, but no difference was observed at 6 months.

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison), by inconsistency (heterogeneity in interventions and outcomes) and by potential reporting bias (only few small trials reported).

Ədəbiyyat

1. Paramothayan S, Lasserson TJ, Walters EH. Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis. Cochrane Database Syst Rev 2006;(3):CD003536.