Cytotoxic Agents in Sarcoidosis: Which One to Choose?
Cytotoxic Agents in Sarcoidosis: Which One to Choose?
Since curative treatment is still not available for sarcoidosis, nonspecific immunosuppression with prednisone remains the first-line therapeutic choice. In case of toxicity or inefficacy, second-line therapeutics, such as MTX, AZA, LEF and hydroxychloroquine, are proven to be effective. Third-line treatment with biologicals is currently reserved for selected patients refractory to standard therapy. Future research should focus on the role for personalized medicine, based on possible pharmacogenetic and phenotypic predictors of response, in the treatment of sarcoidosis.
Conclusion
Since curative treatment is still not available for sarcoidosis, nonspecific immunosuppression with prednisone remains the first-line therapeutic choice. In case of toxicity or inefficacy, second-line therapeutics, such as MTX, AZA, LEF and hydroxychloroquine, are proven to be effective. Third-line treatment with biologicals is currently reserved for selected patients refractory to standard therapy. Future research should focus on the role for personalized medicine, based on possible pharmacogenetic and phenotypic predictors of response, in the treatment of sarcoidosis.