Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis (Cochrane Review)

A substantive amendment to this systematic review was last made on 06 September 2000. Cochrane reviews are regularly checked and updated if necessary.

Background: Immunosuppressive and cytotoxic agents have been used as both an alternative to oral corticosteroids, and as a means of maintaining a low dose of steroids in the treatment of pulmonary sarcoidosis.

Objectives: To determine the efficacy of immunosuppressive and cytotoxic agents in the treatment of pulmonary sarcoidosis.

Search strategy: The Cochrane Airways Group trials register was searched for possible randomised trials. Bibliographies were searched for other potentially relevant trials. Searches were current as of February 2001.

Selection criteria: Randomised controlled trials comparing an immunosuppressive or cytotoxic therapy with a control in patients with pulmonary sarcoidosis were included in the review.

Data collection and analysis: Two reviewers independently extracted data for entry in to the Review Manager statistical package (MetaView 4.1). Pharmaceutical companies and study investigators were contacted for unpublished trials.

Main results: Four studies were included in the review. Trials comparing methotrexate, chloroquine and cyclosporin A were identified. No data could be combined for a meta-analysis. Data on lung function, chest x-ray scores and dyspnoea were largely inconclusive. Adverse effects were associated with methotrexate, cyclosporin A and chloroquine. In one small study, methotrexate was associated with a steroid sparing effect after 12 months of therapy, but no difference was observed at 6 months.

Reviewers' conclusions: The current body of evidence supporting the use of immunosuppressive agents and cytotoxic therapies is limited. Side-effects associated with some of the therapies were severe.

Citation: Paramothayan S, Lasserson T, Walters EH. Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

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This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

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File Reference: AB003536.htm