PERSONIFIED APPROACH TO TREATMENT OF PULMONARY SARCOIDOSIS

Authors

  • Yu. I. Feshchenko F. Yanovskyi National Institute of Phthisiology and Pulmonology P. Shupyk National Medical Academy of Postgraduate Education
  • V. K. Havrysiuk F. Yanovskyi National Institute of Phthisiology and Pulmonology
  • H. L. Humeniuk P. Shupyk National Medical Academy of Postgraduate Education
  • Ye. O. Merenkova F. Yanovskyi National Institute of Phthisiology and Pulmonology
  • Ya. O. Dziubluk F. Yanovskyi National Institute of Phthisiology and Pulmonology
  • S. V. Zaikov P. Shupyk National Medical Academy of Postgraduate Education
  • N. A. Vlasova F. Yanovskyi National Institute of Phthisiology and Pulmonology

DOI:

https://doi.org/10.11603/bmbr.2706-6290.2020.4.11372

Keywords:

pulmonary sarcoidosis, treatment, algorithm of personified therapy

Abstract

Summary. For many years, the main drugs for the treatment of sarcoidosis remain glucocorticosteroids. On average, about 50 % of patients with sarcoidosis (from 30 to 80 %) are treated with corticosteroids. In cases of resistance, contraindications or serious side effects of corticosteroid therapy, second-line drugs are prescribed, the main place among which is held by immunosuppressants. It should be noted that in the course of therapy there may be different variants of the disease, and there are no criteria for the prognosis of regression, stabilization and progression of sarcoidosis. In this regard, the only correct principle of patient management is a personalized approach to therapy.

The aim of the study – to develop an algorithm for personalized therapy of patients with sarcoidosis based on the study of the frequency of contraindications, serious side effects and cases of resistance to glucocorticosteroids, to determine the optimal drug for immunosuppressive therapy.

Materials and Methods. 185 patients with newly diagnosed sarcoidosis with lesions of the lung parenchyma were examined. The study included patients only for newly diagnosed sarcoidosis without any prior specific therapy. The second, important selection criterion was the absence of computed tomography (CT) signs of interstitial pulmonary fibrosis. All patients underwent CT of the thoracic cavity and assessment of lung function (spirometry, bodyplethysmography, diffusion capacity of the lungs).

Results. The obtained results give grounds to consider methotrexate as the drug of choice in the treatment of patients with pulmonary sarcoidosis with contraindications or serious side effects of glucocorticosteroids. Based on the results, an algorithm for personalized therapy of patients with pulmonary sarcoidosis was developed, which considered the contraindications, serious side effects of corticosteroids and resistance to corticosteroid therapy, utilizing the immunosuppressive therapy with methotrexate due to its optimal level of efficacy and safety profile.

Сonclusions. The use of this algorithm of therapy allows achieving clinical cure in the vast majority of patients with pulmonary sarcoidosis.

References

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Published

2021-02-25

How to Cite

Feshchenko, Y. I., Havrysiuk, V. K., Humeniuk, H. L., Merenkova, Y. O., Dziubluk, Y. O., Zaikov, S. V., & Vlasova, N. A. (2021). PERSONIFIED APPROACH TO TREATMENT OF PULMONARY SARCOIDOSIS. Bulletin of Medical and Biological Research, (4), 83–88. https://doi.org/10.11603/bmbr.2706-6290.2020.4.11372

Issue

No. 4 (2020): Bulletin of Medical and Biological Research

Section

Original research

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