| Abstract | 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 Pharmaceutical companies and study investigators were contacted for unpublished trials.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. REVIEWER'S 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. |
| Authors | S Paramothayan, T Lasserson, E H Walters
(Affiliation: Respiratory Medicine, Kingston Hospital NHS Trust, Galsworthy Rd, Kingston Upon Thames, Surrey, UK, KT2 7QB.)
|
| Journal | Cochrane database of systematic reviews (Online)
(Cochrane Database Syst Rev)
Issue 3
Pg. CD003536
( 2003)
ISSN: 1469-493X England |
| PMID | 12917971
(Publication Type: Journal Article, Review)
|
| Chemical References |
- Antineoplastic Agents
- Immunosuppressive Agents
- Chloroquine
- Methotrexate
- Cyclosporine
|
| Topics |
- Antineoplastic Agents
(adverse effects, therapeutic use)
- Chloroquine
(therapeutic use)
- Cyclosporine
(therapeutic use)
- Humans
- Immunosuppressive Agents
(adverse effects, therapeutic use)
- Methotrexate
(therapeutic use)
- Randomized Controlled Trials as Topic
- Sarcoidosis, Pulmonary
(drug therapy)
|
