Abstract
Background This study aimed to evaluate patients with extrapulmonary and
refractory sarcoidosis who were followed up on in our rheumatology clinic for a
long follow-up period and to summarise the applications in rheumatology
practice.
Materials and Methods The study included patients diagnosed with
sarcoidosis at our institution between 2010 and 2022. Patientsʼ age, sarcoidosis
diagnosis dates, inflammatory rheumatic disease (iRMD) diagnoses, autoimmune
markers, and imaging findings were all evaluated. Estimates were made for cases
of glucocorticoid (GC) use and cumulative and mean daily GC exposures.
Results 90 patients with sarcoidosis, 79 (87.8) female and 11 (12.2) male,
whose mean age was 56.4±12.4 years, were included. Since 48 (53.3%) of the
patients required at least one additional treatment in addition to CS, they were
classified as having refractory sarcoidosis and followed up accordingly. While
43 (89%) of the patients received second-line sarcoidosis treatment, it was
found that 5 patients were switched to third-line sarcoidosis treatment
(p<0.001). Comorbidity distributions of refractory and nonrefractory patients
were similar. It was determined that 9 (10%) patients had a history of
osteoporotic fracture.
Conclusions In conclusion, it appears critical to develop a detailed
patient management plan and a multidisciplinary approach in the early stages of
extrapulmonary sarcoidosis management. There is currently no detailed algorithm
covering refractory disease definition and treatment practice differences.
Keywords
sarcoidosis - glucocorticoid - iRMD - osteoporosis - TNFi
Schlüsselwörter
iRMD - TNFi - Sarkoidose - Glukokortikoid - Osteoporose
