Safety of corticosteroid therapy in sarcoidosis treatment

Introduction: Sarcoidosis is a multisystemic granulomatous disease of unknown origin and unpredictable cause, characterized by a dysregulated immune response. If histopathological hallmark is represented by the presence of non-caseating granulomas, clinical manifestations are variable and symptoms a...

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Main Authors: Alessandro Di Marco Berardino, Federico Mei, Lina Zuccatosta
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-12-01
Series:Frontiers in Drug Safety and Regulation
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Online Access:https://www.frontiersin.org/articles/10.3389/fdsfr.2023.1319931/full
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author Alessandro Di Marco Berardino
Federico Mei
Lina Zuccatosta
author_facet Alessandro Di Marco Berardino
Federico Mei
Lina Zuccatosta
author_sort Alessandro Di Marco Berardino
collection DOAJ
description Introduction: Sarcoidosis is a multisystemic granulomatous disease of unknown origin and unpredictable cause, characterized by a dysregulated immune response. If histopathological hallmark is represented by the presence of non-caseating granulomas, clinical manifestations are variable and symptoms are not specific, and they depend on organs affected. Although thoracic involvement (lung and mediastinum) is the most common clinical manifestation, any organ can be virtually affected.Methods: This paper is structured as a narrative review. A literature search was performed in four electronic databases (Pubmed, Cochrane, Scopus, and Ovid Medline) and Google from inception until February 2023 for relevant studies, meta-analyses, and reviews on corticosteroids’ adverse events in sarcoidosis. English language only papers were included.Discussion: Although antimetabolites (such as Methotrexate) and immunosuppressant agents can be used as alternative therapy in refractory cases, traditionally systemic glucocorticoids represent the first choice for sarcoidosis treatment. However, their use is still debated, due to potential adverse effects, leading to a wide spectrum of complications particularly in patients who required long-term therapy. Hence, this article aims to provide a comprehensive updated review on the safety profile of glucocorticoid treatment in patients with sarcoidosis and their systemic effects.Conclusion: corticosteroids remain the first choice in Sarcoidosis, however, due to numerous side effects, dose and duration of treatment should be carefully adjusted and monitored by clinicians.
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spelling doaj-art-199a9dca2f914cd0bb2939d91c799dd92025-08-20T02:23:49ZengFrontiers Media S.A.Frontiers in Drug Safety and Regulation2674-08692023-12-01310.3389/fdsfr.2023.13199311319931Safety of corticosteroid therapy in sarcoidosis treatmentAlessandro Di Marco Berardino0Federico Mei1Lina Zuccatosta2Respiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero Universitaria delle Marche, Ancona, ItalyDepartment of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, ItalyRespiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero Universitaria delle Marche, Ancona, ItalyIntroduction: Sarcoidosis is a multisystemic granulomatous disease of unknown origin and unpredictable cause, characterized by a dysregulated immune response. If histopathological hallmark is represented by the presence of non-caseating granulomas, clinical manifestations are variable and symptoms are not specific, and they depend on organs affected. Although thoracic involvement (lung and mediastinum) is the most common clinical manifestation, any organ can be virtually affected.Methods: This paper is structured as a narrative review. A literature search was performed in four electronic databases (Pubmed, Cochrane, Scopus, and Ovid Medline) and Google from inception until February 2023 for relevant studies, meta-analyses, and reviews on corticosteroids’ adverse events in sarcoidosis. English language only papers were included.Discussion: Although antimetabolites (such as Methotrexate) and immunosuppressant agents can be used as alternative therapy in refractory cases, traditionally systemic glucocorticoids represent the first choice for sarcoidosis treatment. However, their use is still debated, due to potential adverse effects, leading to a wide spectrum of complications particularly in patients who required long-term therapy. Hence, this article aims to provide a comprehensive updated review on the safety profile of glucocorticoid treatment in patients with sarcoidosis and their systemic effects.Conclusion: corticosteroids remain the first choice in Sarcoidosis, however, due to numerous side effects, dose and duration of treatment should be carefully adjusted and monitored by clinicians.https://www.frontiersin.org/articles/10.3389/fdsfr.2023.1319931/fullsarcoidosistreatmentcorticosteroidsdiabetesobesitycardiovascular disease
spellingShingle Alessandro Di Marco Berardino
Federico Mei
Lina Zuccatosta
Safety of corticosteroid therapy in sarcoidosis treatment
Frontiers in Drug Safety and Regulation
sarcoidosis
treatment
corticosteroids
diabetes
obesity
cardiovascular disease
title Safety of corticosteroid therapy in sarcoidosis treatment
title_full Safety of corticosteroid therapy in sarcoidosis treatment
title_fullStr Safety of corticosteroid therapy in sarcoidosis treatment
title_full_unstemmed Safety of corticosteroid therapy in sarcoidosis treatment
title_short Safety of corticosteroid therapy in sarcoidosis treatment
title_sort safety of corticosteroid therapy in sarcoidosis treatment
topic sarcoidosis
treatment
corticosteroids
diabetes
obesity
cardiovascular disease
url https://www.frontiersin.org/articles/10.3389/fdsfr.2023.1319931/full
work_keys_str_mv AT alessandrodimarcoberardino safetyofcorticosteroidtherapyinsarcoidosistreatment
AT federicomei safetyofcorticosteroidtherapyinsarcoidosistreatment
AT linazuccatosta safetyofcorticosteroidtherapyinsarcoidosistreatment