Chest
Clinical InvestigationsSarcoidEarly Treatment of Stage II Sarcoidosis Improves 5-Year Pulmonary Function
Section snippets
Study Design
The 18-month treatment phase was a randomized,placebo-controlled, double-blind, parallel-group, multicenter study aspreviously described.5 The 5-year follow-up study was anopen-label study extension.
Patients
The 18-month treatment phase included 189 randomized patients ofboth genders and ≥ 18 years old. They had newly detected (diagnosedwithin 3 months from the first symptoms or signs) radiographic stage Idisease (bilateral hilar lymphadenopathy; n = 94) or stage II disease(parenchymal infiltrates with
Results
Of the initial 189 randomized patients, 35 patients (16steroid-treated and 19 placebo-treated) did not complete the 18-monthtreatment phase as previously reported.5 Of the 154remaining patients, 149 patients participated in the follow-up part ofthe study. Five patients refused to take part in the follow-up. Figure 1 shows the initial randomization to treatment with corticosteroids orplacebo, separately for patients with stage I and stage II(-III)pulmonary radiographic findings. The number of
Discussion
Corticosteroids are considered to be beneficial in the treatmentof pulmonary sarcoidosis, as their administration usually results inrelief of respiratory symptoms and improvements in lung function andchest radiographic findings.8 Results of controlledclinical studies also show that both systemic9 andinhaled1011 corticosteroid treatment influence cellularand biochemical findings, which appear to be important in theimmunopathogenesis of the disease. However, reappearance of symptomsand
Appendix
In addition to the authors, the following investigators andhospitals were members of the Finnish Study Group on PulmonarySarcoidosis, and participated in the study: Etelaï-Karjala CentralHospital (R. Kauppinen), Etelaï-Pohjanmaa Central Hospital (M.Koskenkari, E. Kokko, L. Tuomisto), Haïrmaï Hospital (E.Aalto), Kanta-Haïme Central Hospital (M. Jaïrvinen),Keski-Pohjanmaa Central Hospital (R. Lillqvist, J-H. Slotte), KiljavaHospital (R. Tammivaara, S. Koskinen), Kuopio University Hospital
ACKNOWLEDGMENT
The authors thank Eeva-Leena Franicevic, RN,Meltola Hospital, and later at AstraZeneca, Finland, for monitoring thestudy.
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Financial support was provided by AstraZeneca, R&D, Lund, Sweden, andAstraZeneca, Finland.
Dr. Persson is a full-time statistician employed by AstraZenecaR&D, Lund, Sweden.
Dr. Selroos, who initiated the study while working asPhysician-in-Chief at Meltola Hospital, Finland, has been appointed amedical advisor to AstraZeneca, R&D, Lund, Sweden.
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A complete list of the members of the Finnish Sarcoidosis Study groupis given in the Appendix.