Document Detail

Pharmacotherapy for pulmonary sarcoidosis: a Delphi consensus study.
MedLine Citation:
PMID:  20089389     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Most issues concerning pharmacotherapy of pulmonary sarcoidosis have not been resolved in clinical trials. The objective was to survey sarcoidosis experts concerning the treatment of pulmonary sarcoidosis and attempt to reach a consensus by these experts using a Delphi method. METHODS: A 6-item questionnaire was developed. Experts were identified at the Diffuse Lung Disease Network at the annual CHEST meeting in October 2008. Three rounds of questionnaires were presented to the experts. Respondent feedback and supporting literature was incorporated into the questionnaires of subsequent rounds. RESULTS: Experts reached a consensus concerning the following issues: (a) corticosteroids are the initial therapy of choice; (b) initial use of inhaled corticosteroids are not recommended; (c) methotrexate was the preferred second-line drug; (d) 40mg of daily prednisone equivalent was the maximum dose recommended for the treatment of acute pulmonary sarcoidosis; (e) tapering to 10mg of daily prednisone equivalent for chronic pulmonary sarcoidosis was considered a successful taper. The experts could not resolve the following issues: (a) the initial corticosteroid dose for the treatment of acute pulmonary sarcoidosis; (b) the decision and timing of corticosteroid therapy in a patient with mild, Stage 2 pulmonary sarcoidosis. CONCLUSIONS: This Delphi study revealed that sarcoidosis experts reached a consensus concerning several aspects of the treatment of pulmonary sarcoidosis; these could be considered as appropriate approaches to therapy. Other issues concerning the therapy of pulmonary sarcoidosis remain unresolved by experts, and are areas where further clinical research could be directed.
Amanda C Schutt; Wendy M Bullington; Marc A Judson
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Publication Detail:
Type:  Journal Article     Date:  2010-01-20
Journal Detail:
Title:  Respiratory medicine     Volume:  104     ISSN:  1532-3064     ISO Abbreviation:  Respir Med     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-03     Completed Date:  2010-10-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  717-23     Citation Subset:  IM    
Medical University of South Carolina Medical Center and College of Pharmacy, Charleston, SC 29425, USA.
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MeSH Terms
Adrenal Cortex Hormones / administration & dosage*
Delphi Technique*
Drug Administration Schedule
Physician's Practice Patterns
Sarcoidosis, Pulmonary / drug therapy*
Reg. No./Substance:
0/Adrenal Cortex Hormones

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