As different as the symptoms, the affected organs and the course of sarcoidosis are, so individually is used in the sarcoidosis therapy. In mild forms of sarcoidosis, regular therapy may be unnecessary, in severe cases, preparations are used in which the benefits and side effects of the therapy must be carefully weighed against each other.
Drug therapy for sarcoidosis
In principle, there are four groups of drugs in a sarcoidosis therapy, which - depending on the extent of the complaints and organ involvement - complement or be used alternatively. Many of these therapeutics are also used in rheumatism and other autoimmune diseases:
- Non-steroidal anti-inflammatory drugs (NSAIDs): Preparations such as diclofenac and ibuprofen, as well as acetylsalicylic acid (ASA) mainly help against the inflammation-related pain in joints and muscles and are therefore the first choice in acute sarcoidosis.
- Cortisone: This hormone (and its derivatives) is anti-inflammatory and is the drug of first choice for chronic sarcoidosis. It is intended to prevent further granulomas from forming. The dose and duration of sarcoidosis therapy depends on many factors such as stage and past disease, organ involvement, the condition of the patient and complications occurred. Mostly, sarcoidosis therapy with cortisone tablets lasts for six to nine months in lung sarcoidosis and other organ involvement, rarely longer. Skin changes and eye inflammation can also be treated with ointments. It is important not to interrupt the sarcoidosis therapy too soon, as this increases the risk of relapses. In addition, the dose must be slowly reduced ("sneak out").
- Immunosuppressants and cytostatics are used when the symptoms do not improve with the other agents. They sometimes have serious side effects, so their use must be well balanced and under close control. The most commonly used drugs in sarcoidosis are methotrexate (MTX), azathioprine and pentoxifylline; in particularly severe cases cyclophosphamide is also used.
- Rarely, chloroquine is also used - a remedy that is not only indicated in immune disorders, but especially in malaria.
At stage IV of pulmonary involvement, saccular bronchiectasis (bronchiectasis) often occurs. These are prone to infections, so that often a sarcoidosis therapy with antibiotics is needed. For skin sarcoidosis, a trial with allopurinol may be indicated. It has shown a positive effect in several studies, without the mechanism of action in the sarcoidosis therapy is decrypted.
Supplementary therapy for sarcoidosis
Depending on the involvement of the organ, further therapies in the context of sarcoidosis therapy are indicated. Thus, the use of a pacemaker or defibrillator may be useful in cardiac involvement. In case of advanced involvement of the lungs or the heart, it may be necessary to discuss a transplantation of the relevant organs. In addition, the anthroposophic therapy with phosphorus, iron and graphite, supported by mistletoe preparations, the self-healing powers of the body to stimulate.
However, there is no scientific confirmation of the effectiveness of sarcoidosis.