Delphi consensus recommendations for a treatment algorithm in pulmonary sarcoidosis

Franck F Rahaghi; Robert P Baughman; Lesley Ann Saketkoo; Nadera J Sweiss; Joseph B Barney; Surinder S Birring; Ulrich Costabel; Elliott D Crouser; Marjolein Drent; Alicia K Gerke; Jan C Grutters; Nabeel Y Hamzeh; Isham Huizar; W Ennis James IV; Sanjay Kalra; Susanna Kullberg; Huiping Li; Elyse E Lower; Lisa A Maier; Mehdi Mirsaeidi; Joachim Müller-Quernheim; Eva M Carmona Porquera; Lobelia Samavati; Dominique Valeyre; Mary Beth Scholand

doi:10.1183/16000617.0146-2019

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Delphi consensus recommendations for a treatment algorithm in pulmonary sarcoidosis

Journal article

Open access

Peer reviewed

Delphi consensus recommendations for a treatment algorithm in pulmonary sarcoidosis

Franck F Rahaghi, Robert P Baughman, Lesley Ann Saketkoo, Nadera J Sweiss, Joseph B Barney, Surinder S Birring, Ulrich Costabel, Elliott D Crouser, Marjolein Drent, Alicia K Gerke, …

European respiratory review, Vol.29(155), p.190146

03/31/2020

DOI: 10.1183/16000617.0146-2019

PMCID: PMC9488897

PMID: 32198218

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https://doi.org/10.1183/16000617.0146-2019View

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Abstract

Pulmonary sarcoidosis presents substantial management challenges, with limited evidence on effective therapies and phenotypes. In the absence of definitive evidence, expert consensus can supply clinically useful guidance in medicine. An international panel of 26 experts participated in a Delphi process to identify consensus on pharmacological management in sarcoidosis with the development of preliminary recommendations.The modified Delphi process used three rounds. The first round focused on qualitative data collection with open-ended questions to ensure comprehensive inclusion of expert concepts. Rounds 2 and 3 applied quantitative assessments using an 11-point Likert scale to identify consensus.Key consensus points included glucocorticoids as initial therapy for most patients, with non-biologics (immunomodulators), usually methotrexate, considered in severe or extrapulmonary disease requiring prolonged treatment, or as a steroid-sparing intervention in cases with high risk of steroid toxicity. Biologic therapies might be considered as additive therapy if non-biologics are insufficiently effective or are not tolerated with initial biologic therapy, usually with a tumour necrosis factor-α inhibitor, typically infliximab.The Delphi methodology provided a platform to gain potentially valuable insight and interim guidance while awaiting evidenced-based contributions.

Algorithms

Adrenal Cortex Hormones - adverse effects

Adrenal Cortex Hormones - therapeutic use

Biological Products - adverse effects

Biological Products - therapeutic use

Clinical Decision-Making

Consensus

Decision Support Techniques

Delphi Technique

Humans

Immunologic Factors - adverse effects

Immunologic Factors - therapeutic use

Lung - drug effects

Lung - physiopathology

Sarcoidosis, Pulmonary - diagnosis

Sarcoidosis, Pulmonary - drug therapy

Sarcoidosis, Pulmonary - physiopathology

Severity of Illness Index

Details

Title: Subtitle: Delphi consensus recommendations for a treatment algorithm in pulmonary sarcoidosis
Creators: Franck F Rahaghi - Cleveland Clinic Florida
Robert P Baughman - University of Cincinnati
Lesley Ann Saketkoo - Tulane University
Nadera J Sweiss - University of Illinois Chicago
Joseph B Barney - University of Alabama at Birmingham
Surinder S Birring - King's College Hospital
Ulrich Costabel - Ruhrlandklinik
Elliott D Crouser - The Ohio State University Wexner Medical Center
Marjolein Drent - ILD (Czechia)
Alicia K Gerke - University of Iowa
Jan C Grutters - St. Antonius Ziekenhuis
Nabeel Y Hamzeh - University of Iowa
Isham Huizar - Texas Tech University Health Sciences Center
W Ennis James IV - Medical University of South Carolina
Sanjay Kalra - Mayo CLinic, Rochester, MN, USA,
Susanna Kullberg - Karolinska University Hospital
Huiping Li - Shanghai Pulmonary Hospital
Elyse E Lower - University of Cincinnati
Lisa A Maier - National Jewish Health
Mehdi Mirsaeidi - University of Miami
Joachim Müller-Quernheim - University Medical Center Freiburg
Eva M Carmona Porquera - Mayo Clinic, Rochester, MN, USA
Lobelia Samavati - Wayne State University
Dominique Valeyre - Université Paris Cité
Mary Beth Scholand - University of Utah
Resource Type: Journal article
Publication Details: European respiratory review, Vol.29(155), p.190146
DOI: 10.1183/16000617.0146-2019
PMID: 32198218
PMCID: PMC9488897
NLM abbreviation: Eur Respir Rev
ISSN: 0905-9180
eISSN: 1600-0617
Language: English
Date published: 03/31/2020
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
Record Identifier: 9984359689702771

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