2021 ERS临床实践指南：结节病的治疗（英文）

ERS clinical practice guidelines on treatment of sarcoidosis

Background The major reasons to treat sarcoidosis are to lower the morbidity and mortality risk or to
improve quality of life (QoL). The indication for treatment varies depending on which manifestation is the
cause of symptoms: lungs, heart, brain, skin or other manifestations. While glucocorticoids remain the first
choice for initial treatment of symptomatic disease, prolonged use is associated with significant toxicity.
Glucocorticoid-sparing alternatives are available. The presented treatment guidelines aim to provide
guidance to physicians treating the very heterogenous sarcoidosis manifestations.
Methods A European Respiratory Society Task Force committee composed of clinicians, methodologists
and patients with experience in sarcoidosis developed recommendations based on the GRADE (Grading of
Recommendations, Assessment, Development and Evaluations) methodology. The committee developed
eight PICO (Patients, Intervention, Comparison, Outcomes) questions and these were used to make specific
evidence-based recommendations.
Results The Task Force committee delivered 12 recommendations for seven PICOs. These included
treatment of pulmonary, cutaneous, cardiac and neurologic disease as well as fatigue. One PICO question
regarding small-fibre neuropathy had insufficient evidence to support a recommendation. In addition to the
recommendations, the committee provided information on how they use alternative treatments, when there
was insufficient evidence to support a recommendation.