Clinical characteristics of patients with pulmonary sarcoidosis treated with systemic steroids in Japan
BackgroundSevere pulmonary sarcoidosis is less common in Japan than in other countries, and the actual clinical situation of systemic steroid use in Japan requires clarification.MethodsThis study analyzed 65 patients with histologically diagnosed sarcoidosis who initially received systemic steroids...
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Frontiers Media S.A.
2025-05-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1567334/full |
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| author | Michiru Sawahata Hirokazu Kimura Takeshi Hattori Tsutomu Tamada Masashi Bando Makoto Maemondo Takeshi Kawanobe Chiyoko Kono Tetsuo Yamaguchi Noriharu Shijubo Takafumi Suda Satoshi Konno |
| author_facet | Michiru Sawahata Hirokazu Kimura Takeshi Hattori Tsutomu Tamada Masashi Bando Makoto Maemondo Takeshi Kawanobe Chiyoko Kono Tetsuo Yamaguchi Noriharu Shijubo Takafumi Suda Satoshi Konno |
| author_sort | Michiru Sawahata |
| collection | DOAJ |
| description | BackgroundSevere pulmonary sarcoidosis is less common in Japan than in other countries, and the actual clinical situation of systemic steroid use in Japan requires clarification.MethodsThis study analyzed 65 patients with histologically diagnosed sarcoidosis who initially received systemic steroids for pulmonary lesions and made regular outpatient visits to Hokkaido University Hospital, JR Sapporo Hospital, or JR Tokyo General Hospital in September 2017.ResultsMedian age at diagnosis was 35 (interquartile range [IQR] 26–48) years. Thirty-four patients (52.3%) were men. Median time from diagnosis to steroid initiation was 5 (IQR, 1–9) years. Median maximum steroid dose was prednisolone (PSL) 30 (range 5–60) mg/day. Immunosuppressants were used in 19 patients (29.2%). Twenty-one patients (32.3%) received PSL ≤ 10 mg/day and 7 (10.8%) received 5 mg/day. The PSL ≤ 10 mg/day group included a significantly lower proportion of men than the group treated with higher doses (33.3% vs. 61.4%, p = 0.034). Most cases were effectively treated, but some required long-term steroid administration. Even when steroid inhalation therapy was ineffective, systemic administration of PSL 5 mg/day effectively resolved chest imaging findings and respiratory symptoms. The successful steroid withdrawal rate was 18.5% overall, increasing to 23.8 and 42.9% in the PSL ≤ 10 mg/day and 5 mg/day groups, respectively.ConclusionApproximately one-third of patients received an initial steroid dose of PSL ≤ 10 mg/day for pulmonary sarcoidosis. This was mostly effective and the withdrawal rate was relatively high. Our results support that some Japanese patients with pulmonary sarcoidosis may successfully receive an initial dose of PSL ≤ 10 mg/day. |
| format | Article |
| id | doaj-art-7bc0f36154b34f778bce828b153a8a52 |
| institution | DOAJ |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-7bc0f36154b34f778bce828b153a8a522025-08-20T03:12:50ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-05-011210.3389/fmed.2025.15673341567334Clinical characteristics of patients with pulmonary sarcoidosis treated with systemic steroids in JapanMichiru Sawahata0Hirokazu Kimura1Takeshi Hattori2Tsutomu Tamada3Masashi Bando4Makoto Maemondo5Takeshi Kawanobe6Chiyoko Kono7Tetsuo Yamaguchi8Noriharu Shijubo9Takafumi Suda10Satoshi Konno11Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, JapanDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, JapanDepartment of Respiratory Medicine, National Hospital Organization Hokkaido Medical Center, Sapporo, Hokkaido, JapanDepartment of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, JapanDivision of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, JapanDivision of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, JapanDepartment of Respiratory Medicine, JR Tokyo General Hospital, Shibuya, Tokyo, JapanDepartment of Respiratory Medicine, JR Tokyo General Hospital, Shibuya, Tokyo, JapanDepartment of Respiratory Medicine, Shinjuku Tsurukame Clinic, Shibuya, Tokyo, JapanDepartment of Respiratory Medicine, JR Sapporo Hospital, Sapporo, Hokkaido, JapanSecond Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, JapanDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, JapanBackgroundSevere pulmonary sarcoidosis is less common in Japan than in other countries, and the actual clinical situation of systemic steroid use in Japan requires clarification.MethodsThis study analyzed 65 patients with histologically diagnosed sarcoidosis who initially received systemic steroids for pulmonary lesions and made regular outpatient visits to Hokkaido University Hospital, JR Sapporo Hospital, or JR Tokyo General Hospital in September 2017.ResultsMedian age at diagnosis was 35 (interquartile range [IQR] 26–48) years. Thirty-four patients (52.3%) were men. Median time from diagnosis to steroid initiation was 5 (IQR, 1–9) years. Median maximum steroid dose was prednisolone (PSL) 30 (range 5–60) mg/day. Immunosuppressants were used in 19 patients (29.2%). Twenty-one patients (32.3%) received PSL ≤ 10 mg/day and 7 (10.8%) received 5 mg/day. The PSL ≤ 10 mg/day group included a significantly lower proportion of men than the group treated with higher doses (33.3% vs. 61.4%, p = 0.034). Most cases were effectively treated, but some required long-term steroid administration. Even when steroid inhalation therapy was ineffective, systemic administration of PSL 5 mg/day effectively resolved chest imaging findings and respiratory symptoms. The successful steroid withdrawal rate was 18.5% overall, increasing to 23.8 and 42.9% in the PSL ≤ 10 mg/day and 5 mg/day groups, respectively.ConclusionApproximately one-third of patients received an initial steroid dose of PSL ≤ 10 mg/day for pulmonary sarcoidosis. This was mostly effective and the withdrawal rate was relatively high. Our results support that some Japanese patients with pulmonary sarcoidosis may successfully receive an initial dose of PSL ≤ 10 mg/day.https://www.frontiersin.org/articles/10.3389/fmed.2025.1567334/fullsarcoidosissteroidtreatmentimmunosuppressantguideline |
| spellingShingle | Michiru Sawahata Hirokazu Kimura Takeshi Hattori Tsutomu Tamada Masashi Bando Makoto Maemondo Takeshi Kawanobe Chiyoko Kono Tetsuo Yamaguchi Noriharu Shijubo Takafumi Suda Satoshi Konno Clinical characteristics of patients with pulmonary sarcoidosis treated with systemic steroids in Japan Frontiers in Medicine sarcoidosis steroid treatment immunosuppressant guideline |
| title | Clinical characteristics of patients with pulmonary sarcoidosis treated with systemic steroids in Japan |
| title_full | Clinical characteristics of patients with pulmonary sarcoidosis treated with systemic steroids in Japan |
| title_fullStr | Clinical characteristics of patients with pulmonary sarcoidosis treated with systemic steroids in Japan |
| title_full_unstemmed | Clinical characteristics of patients with pulmonary sarcoidosis treated with systemic steroids in Japan |
| title_short | Clinical characteristics of patients with pulmonary sarcoidosis treated with systemic steroids in Japan |
| title_sort | clinical characteristics of patients with pulmonary sarcoidosis treated with systemic steroids in japan |
| topic | sarcoidosis steroid treatment immunosuppressant guideline |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1567334/full |
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