Highlights
- •Patients with sarcoidosis prioritised quality of life when considering new therapies.
- •Corticosteroid withdrawal was not the highest priority.
- •Side effects during a treatment course were accepted if overall symptoms improved.
- •Patients were sceptical towards the concept of remission.
- •Patients made a clear distinction between ‘living with a condition’ and ‘being ill’.
Abstract
Background
Sarcoidosis is a multisystem disease, characterised by the infiltration of various
organs by non-necrotising granulomas. The disease's heterogeneity complicates the
study of patients' experiences.
Objective
To gather insight into life experiences, unmet needs and views on hypothetically emerging
treatment options among patients living with sarcoidosis.
Methods
Multinational, virtual, interactive, moderated discussion of specific questions between
people with sarcoidosis, with experienced clinicians participating.
Results
Nine patients with sarcoidosis from Australia, Denmark, Germany, Italy, Japan and
the US, and three clinicians took part. All patients had pulmonary sarcoidosis, self-assessed
as mild by five patients. The path to diagnosis was convoluted, with up to four physicians
and a large number of tests involved. There was agreement that the process would be
improved by earlier referral to specialists. The patients made a clear distinction
between ‘living with a condition’ (adapting to the disease) and ‘being ill’. The concept
of remission was viewed sceptically as disease might develop in multiple organs. Panellists
had a pragmatic attitude to therapies: side effects during a treatment course were
accepted if overall symptoms improved. When considering hypothetical new therapies,
improved quality of life (QoL) was the most important need; improved tolerability
had lower priority. New therapies should be targeted on reducing disease progression
and improving symptoms and QoL rather than corticosteroid withdrawal.
Conclusions
The interactive exchange provided insights into the need for earlier specialist referrals,
distrust of the concept of remission in sarcoidosis, and the need for therapies targeted
on reducing disease progression and improving symptoms and QoL.
Keywords
Abbreviations:
SFN (small fiber neuropathy), DMARDs (antimetabolites and disease-modifying antirheumatic drugs), ATS (American Thoracic Society), ERS (European Respiratory Society), HRQoL (health related quality of life), KSQ (Kings Sarcoidosis Questionnaire), SHQ (sarcoidosis health questionnaire), FAS (fatigue assessment scale), SAT (sarcoiodosis assessment tool), PGA (patient global assessment), HCP (health care provider)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 02, 2023
Accepted:
February 26,
2023
Received in revised form:
February 23,
2023
Received:
December 21,
2022
Identification
Copyright
© 2023 Published by Elsevier Ltd.
