RT Journal Article
SR Electronic
T1 Clinical phenotyping: role in treatment decisions in sarcoidosis
JF European Respiratory Review
JO EUROPEAN RESPIRATORY REVIEW
FD European Respiratory Society
SP 190145
DO 10.1183/16000617.0145-2019
VO 29
IS 155
A1 Baughman, Robert P.
A1 Scholand, Mary Beth
A1 Rahaghi, Franck F.
YR 2020
UL http://err.ersjournals.com/content/29/155/190145.abstract
AB 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