Advertisement

Why doesn’t anyone want to cure sarcoidosis?: The neglect of disease termination

Published:November 24, 2022DOI:https://doi.org/10.1016/j.rmed.2022.107063
      Sarcoidosis frequently resolves. Resolution rates of sarcoidosis vary depending on the population that is studied. A Spanish sarcoidosis cohort of 193 patients reported that 160 (83%) achieved resolution.
      • Mana J.
      • Salazar A.
      • Manresa F.
      Clinical factors predicting persistence of activity in sarcoidosis: a multivariate analysis of 193 cases.
      These authors and others
      • Romer F.K.
      Presentation of sarcoidosis and outcome of pulmonary changes.
      have found that resolution of sarcoidosis usually occurs within the first two years after diagnosis, and resolution of active disease beyond two years only occurs 10% of the time. However, data from Japanese and Swedish sarcoidosis cohorts found increasing rates of chest radiograph resolution for five years, with few additional resolutions beyond that point.
      • Nagai S.
      • Shigematsu M.
      • Hamada K.
      • Izumi T.
      Clinical courses and prognoses of pulmonary sarcoidosis.
      • Hillerdal G.
      • Nou E.
      • Osterman K.
      • Schmekel B.
      Sarcoidosis: epidemiology and prognosis. A 15-year European study.
      • Pietinalho A.
      • Ohmichi M.
      • Lofroos A.B.
      • Hiraga Y.
      • Selroos O.
      The prognosis of pulmonary sarcoidosis in Finland and Hokkaido, Japan. A comparative five-year study of biopsy-proven cases.
      The cumulative 5-year chest radiograph resolution rate was 60% and 80% in the Japanese and Swedish sarcoidosis cohorts respectively.
      • Nagai S.
      • Shigematsu M.
      • Hamada K.
      • Izumi T.
      Clinical courses and prognoses of pulmonary sarcoidosis.
      • Hillerdal G.
      • Nou E.
      • Osterman K.
      • Schmekel B.
      Sarcoidosis: epidemiology and prognosis. A 15-year European study.
      • Pietinalho A.
      • Ohmichi M.
      • Lofroos A.B.
      • Hiraga Y.
      • Selroos O.
      The prognosis of pulmonary sarcoidosis in Finland and Hokkaido, Japan. A comparative five-year study of biopsy-proven cases.
      An analysis of 818 British sarcoidosis patients found that slightly more than half had resolution of disease within 2 years.
      • Neville E.
      • Walker A.N.
      • James D.G.
      Prognostic factors predicting the outcome of sarcoidosis: an analysis of 818 patients.
      The World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) Task Force of 10 sarcoidosis referral centers found that one-quarter of their sarcoidosis patients did not require treatment for more than one year.
      • Baughman R.P.
      • Nagai S.
      • Balter M.
      • et al.
      Defining the clinical outcome status (COS) in sarcoidosis: results of WASOG Task Force.
      Regardless of these differing resolution rates that were confounded by varying definitions of a sarcoidosis resolution, it is clear that a sizeable proportion of sarcoidosis patients experience termination of their disease.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Respiratory Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Mana J.
        • Salazar A.
        • Manresa F.
        Clinical factors predicting persistence of activity in sarcoidosis: a multivariate analysis of 193 cases.
        Respiration. 1994; 61: 219-225
        • Romer F.K.
        Presentation of sarcoidosis and outcome of pulmonary changes.
        Dan Med Bull. 1982; 29: 27-32
        • Nagai S.
        • Shigematsu M.
        • Hamada K.
        • Izumi T.
        Clinical courses and prognoses of pulmonary sarcoidosis.
        Curr Opin Pulm Med. 1999; 5: 293-298
        • Hillerdal G.
        • Nou E.
        • Osterman K.
        • Schmekel B.
        Sarcoidosis: epidemiology and prognosis. A 15-year European study.
        Am Rev Respir Dis. 1984; 130: 29-32
        • Pietinalho A.
        • Ohmichi M.
        • Lofroos A.B.
        • Hiraga Y.
        • Selroos O.
        The prognosis of pulmonary sarcoidosis in Finland and Hokkaido, Japan. A comparative five-year study of biopsy-proven cases.
        Sarcoidosis Vasc Diffuse Lung Dis. 2000; 17: 158-166
        • Neville E.
        • Walker A.N.
        • James D.G.
        Prognostic factors predicting the outcome of sarcoidosis: an analysis of 818 patients.
        Q J Med. 1983; 52: 525-533
        • Baughman R.P.
        • Nagai S.
        • Balter M.
        • et al.
        Defining the clinical outcome status (COS) in sarcoidosis: results of WASOG Task Force.
        Sarcoidosis Vasc Diffuse Lung Dis. 2011; 28: 56-64
        • Panselinas E.
        • Judson M.A.
        Acute pulmonary exacerbations of sarcoidosis.
        Chest. 2012; 142: 827-836
        • Gottlieb J.E.
        • Israel H.L.
        • Steiner R.M.
        • Triolo J.
        • Patrick H.
        Outcome in sarcoidosis. The relationship of relapse to corticosteroid therapy.
        Chest. 1997; 111: 623-631
        • Baughman R.P.
        • Judson M.A.
        • Teirstein A.
        • et al.
        Presenting characteristics as predictors of duration of treatment in sarcoidosis.
        Qjm. 2006; 99: 307-315
        • Kobak S.
        Regression of Sarcoidosis during Pregnancy: Case Report and Review of the Literature.
        Mediterr J Rheumatol. 2020; 31: 416-420
        • Zissel G.
        • Muller-Quernheim J.
        Specific antigen(s) in sarcoidosis: a link to autoimmunity?.
        Eur Respir J. 2016; 47: 707-709
        • Haggmark A.
        • Hamsten C.
        • Wiklundh E.
        • et al.
        Proteomic profiling reveals autoimmune targets in sarcoidosis.
        Am J Respir Crit Care Med. 2015; 191: 574-583
        • Tchernev G.
        • Wollina U.
        Bacterial antigens and molecular mimicry: the bridging common problematic link in the pathogenesis of sarcoidosis and sarcoid-like reactions: Isn't it time to wake up?.
        Wien Med Wochenschr. 2014; 164: 260-262
      1. YRMED-D-22-00729R1

        • Panselinas E.
        • Rodgers J.K.
        • Judson M.A.
        Clinical outcomes in sarcoidosis after cessation of infliximab treatment.
        Respirology. 2009; 14 (This was changed from ref #15 to ref #16 with YRMED-D-22-00729R1 reference added): 522-528
        • Vorselaars A.D.
        • Verwoerd A.
        • van Moorsel C.H.
        • Keijsers R.G.
        • Rijkers G.T.
        • Grutters J.C.
        Prediction of relapse after discontinuation of infliximab therapy in severe sarcoidosis.
        Eur Respir J. 2014; 43 (This was changed from ref #16 to ref #17 with YRMED-D-22-00729R1 reference added): 602-609