ABSTRACT
The decision to treat sarcoidosis is one of themajor decisions for patients and
physicians. In the past, corticosteroids were considered to be the usual therapy. However, it was clear that the toxicity of corticosteroids led to the
need for alternatives to corticosteroids. In this chapter,wediscuss the alterna-
tives, including dosage and indication. In many cases, these drugs have been
studied only in open label, noncomparator studies. In a recent Cochrane ana-
lysis, only four studieswere considered adequate clinical trials to comment on
efficacy and only one trial [of methotrexate (MTX)] met all the criteria for an
adequate double-blind, randomized trial (1). Despite these limitations, it is
clear that these drugs have a role in treating sarcoidosis. In Table 1, we have listed the general classifications of possible
therapies for sarcoidosis and included the drugs in each classification.
We will discuss each of the drugs in these general categories.