Medical treatment can be used to control symptoms, prevent complications, and improve outcomes in patients with persistent sarcoidosis. If you have sarcoidosis, your health care provider will carefully monitor you to see if your sarcoidosis is getting better or worse, and will adapt your treatment depending on how your body is doing. Many physicians will choose to treat when your quality of life is severely or when they believe there is danger of organ damage or death.
In many cases of sarcoidosis, no treatment is necessary and sarcoidosis may go away without medical treatment. The disease may never reappear or may reappear later in life. However, many other patients need consistent treatment for the ongoing effects of sarcoidosis.
Sarcoidosis is often treated with the help of a multidisciplinary team of health care professionals. Because the disease can affect so many organ systems, you may work with health care providers who specialize in the treatment of the lungs, heart, brain, kidneys, liver, eyes, and skin. At specialized medical centers, these health care providers work as a team to develop a comprehensive treatment plan to control your symptoms and protect your overall health.
Types of medications used to treat sarcoidosis
- Corticosteroids: Corticosteroids reduce inflammation. They are not the same as anabolic steroids, the type of steroid that is sometimes abused by athletes. Corticosteroids are the primary treatment for sarcoidosis. Treatment with corticosteroids relieves symptoms in most people within a few months. The most commonly used corticosteroids are prednisone and prednisolone. People with sarcoidosis may need to take corticosteroids for many months. Because these medications can cause side effects (including weight gain, insomnia, mood swings, acne, difficulty regulating blood sugar, and bone loss), your health care provider will gradually decrease your dose of medication after you start to take it. The goal is to stabilize symptoms without unnecessary exposure to more corticosteroids than you need to control the disease. Learn more about corticosteroids and questions you can ask your doctor before starting treatment.
- Immune system suppressant medication: Because sarcoidosis may be the result of an overreaction of the immune system, suppressing the immune system may ease symptoms and prevent further organ damage. When corticosteroids are not effective, your provider may talk with you about starting other medications, including methotrexate, azathioprine, and mycophenolate mofetil (CellCept). Other medications may help a few patients who do not respond to other therapies. They may include cyclophosphamide and biologic response modifiers (biologics or TNF-blockers).
- Antimalarial drugs: These medications were originally used (and are still used) to treat malaria. As a treatment for sarcoidosis, these drugs are most likely to be effective in people who have skin symptoms or a high level of calcium in their blood. Hydroxychloroquine (Plaquenil) and chloroquine (Aralen) are antimalarial drugs that are used to treat sarcoidosis. Both can cause stomach irritation and eye problems.
People with severe or advanced lung sarcoidosis may need oxygen therapy. In a few cases, lung transplantation – the replacement of a diseased lung or lungs with a healthy donor lung – is used to treat severe lung sarcoidosis.