Traditional Treatment

There is not a cure for sarcoidosis, and the goal of a treatment plan is to relieve the patient’s symptoms, reduce inflammation of affected organs, slow the development of granuloma, prevent irreversible organ damage, and improve quality of life.  

For many patients sarcoidosis improves on its own and they do not require treatment. However, patients not requiring treatment should continue consultation with a medical professional in the management of the disease. Patients who require treatment are to work closely with their physician in the development of a treatment plan, and be closely monitored. It is advised that patients are knowledgable of the adverse side effects for the medications which have been prescribed for treatment. Careful consideration should be given to determine if the side effects of the medications outweigh the possible benefits of the proposed treatment.   

Acthar Gel

*Acthar Gel is a highly purified preparation of adrenocorticotropin hormone (ACTH) obtained from pituitary glands isolated from pigs, which is mixed with a gel and injected subcutaneously or intramuscularly so that it is released slowly into the bloodstream.

The ACTH hormone in Acthar Gel binds to melanocortin receptors (MCRs) in the adrenal glands on the kidneys and stimulates the production of natural corticosteroid hormones such as cortisol. These natural corticosteroids will then suppress the inflammatory and immune processes that are responsible for sarcoidosis. Possible side effects of Acthar Gel include infections, stomach ulcers, insomnia, acne, thinning skin, and high blood pressure.

Acthar was successful in awakening the adrenal glands for a sarcoidosis patient who had been on prednisone treatment for more than 30 years.  The patient’s adrenal glands were depleted as a result of having been on prednisone for decades.  However, the Acthar treatment achieved the goal of reawakening the adrenal glands, and appeared to be beneficial to the patient’s sarcoidosis-related health issues. 

*Source:  Sarcoidosis News

Corticosteroids

Corticosteroids or prednisone, are effective in reducing inflammation, and are commonly used in the treatment of sarcoidosis. Prednisone can have very serious adverse side effects if taken for extended periods of time. It is advised that patients are treated with prednisone for a short period of time, and then be tapered off with the improvement of symptoms. Side effects of prednisone include excessive weight gain, insomnia, acne, diabetes, high blood pressure, glaucoma, cataracts, osteoporosis, depression and emotional irritability, skin bruising, and increased risk of infections.

Cyclophosphamide

Cyclophosphamide is a chemotherapy used to suppress the immune system. It is generally used for severe cases of sarcoidosis such as neurosarcoidosis and cardiac sarcoidosis, and only after other therapies have failed. Side effects of cyclophosphamide can be severe including bone marrow suppression, kidney damage, stomach discomfort, general weakness, diarrhea, nausea, vomiting, and low white blood cell counts.

Hydroxychloroquine (Plaquenil)

Hydroxychloroquine (Plaquenil) and chloroquine are antimalarials, which are usually used to treat malaria, and may help with sarcoidosis of the skin, joints, lungs and nervous system. Side effects of hydroxychloroquine may include headache, dizziness, loss of appetite, nausea, stomach pain, hair loss, blurred vision, light sensitivity, seeing halos around lights, and seizures.

Infliximab (Remicade)

Infliximab (Remicade) or adalimumab (Humira) have proven to be effective in treating inflammation in chronic sarcoidosis, and are only used after other standard treatments are unsuccessful or not tolerated. It is administered intravenously under the skin every four to eight weeks, and every one to two weeks for severe cases of sarcoidosis. Side effects of Infliximab include respiratory infections, headaches, stomach pain, coughing, heart failure, rapid weight gain, easy bruising, hives, muscle or joint pain.

Methotrexate, leflunomide, or azathioprine

Methotrexate, leflunomide, or azathioprine have been used with, or sometimes instead of, prednisone to suppress the immune system. Methotrexate can be taken once a week orally or as an injection. Side effects of these medications include liver toxicity, hair loss, seizures, blurred vision, and potential harm to an unborn child. Patients taking methotrexate should not drink alcohol.

NSAIDs

Non-steroidal anti-inflammatory drugs NSAIDs (ibuprofen or aspirin) are helpful in the reduction of acute inflammation, and to relieve arthritic pain and fever.

Organ transplantation

Organ transplantation has a high success rate among many patients, although in some cases, the disease has been reported to reoccur in the newly transplanted lung. The risks associated with a lung transplant include bleeding, infections, blocked blood vessels or airways, blood or fluid in the lungs, and rejection.

Topical corticosteroids

Topical corticosteroids formulations are available as eye drops, skin creams, gels, lotions, and respiratory sprays; and can be helpful for mild local symptoms of sarcoidosis. Topical corticosteroids are generally less effective than oral steroids, but are considered safer to use with fewer side effects which include itching, burning, redness, dryness, or irritation.

Please see the Complementary Medicine section of this website.

Complementary medicine is described as therapeutic techniques that are not part of traditional medical treatments, and are combined with other conventional medicine to create safe and effective treatment plans for patients.  The combination of traditional and complementary medicine considers how illnesses affect patients physically, emotionally, spiritually, and socially. 

Complementary treatments are not intended to replace any traditional medical treatment plan, and patients’ primary healthcare professionals should be consulted to discuss if any of these treatments are safe and appropriate for your use.