TY - JOUR T1 - Clinical phenotyping: role in treatment decisions in sarcoidosis JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW DO - 10.1183/16000617.0145-2019 VL - 29 IS - 155 SP - 190145 AU - Robert P. Baughman AU - Mary Beth Scholand AU - Franck F. Rahaghi Y1 - 2020/03/31 UR - http://err.ersjournals.com/content/29/155/190145.abstract N2 - A variety of phenotypic categorisations have been developed for sarcoidosis. Phenotyping has been used for genetics studies and to guide treatment selection. The authors participated in a Delphi expert consensus panel to develop a proposed phenotype categorisation and treatment recommendations for pulmonary sarcoidosis patients. Panellists reached consensus that asymptomatic patients with normal pulmonary function and adenopathy alone or normal chest imaging do not require therapy, while symptomatic patients with impaired pulmonary function or infiltrates should be treated. The panel did not reach consensus on asymptomatic patients with abnormal chest imaging or reduced pulmonary function, or symptomatic patients with normal chest imaging and pulmonary function. The proposed phenotype categories and associated treatment recommendations are asymptomatic (no therapy), acute (disease duration <1–2 years, apparently self-limited, corticosteroids), chronic (antimetabolites and other second-line therapies) and advanced (biologics). Some clinical settings, such as dyspnoea/hypoxaemia at rest, severely impaired or rapidly decreasing pulmonary function tests, and severe cardiac, neurologic, ocular or renal involvement warrant immediate therapy.Expert Delphi consensus recommendations on clinical phenotyping to guide therapy for pulmonary sarcoidosis – asymptomatic: no therapy; acute: corticosteroids; chronic: cytotoxics plus other second line; advanced: biologics plus other third line. http://bit.ly/38Lio7U ER -