Patterns of medication use and imaging following initial diagnosis of sarcoidosis

J. Simmering; E.M. Stapleton; P.M. Polgreen; J. Kuntz; A.K. Gerke

doi:10.1016/j.rmed.2021.106622

Back

Patterns of medication use and imaging following initial diagnosis of sarcoidosis

Journal article

Open access

Peer reviewed

Patterns of medication use and imaging following initial diagnosis of sarcoidosis

J. Simmering, E.M. Stapleton, P.M. Polgreen, J. Kuntz and A.K. Gerke

Respiratory medicine, Vol.189, pp.106622-106622

11/2021

DOI: 10.1016/j.rmed.2021.106622

PMCID: PMC10918686

PMID: 34600163

Files and links (1)

url

https://doi.org/10.1016/j.rmed.2021.106622View

Published (Version of record) Open Access

Abstract

Sarcoidosis is a rare inflammatory disease with unclear natural history. Using a large, retrospective, longitudinal, population-based cohort, we sought to define its natural history in order to guide future clinical studies. We identified 722 newly diagnosed cases of sarcoidosis within Kaiser Permanente Northwest health care records between 1995 and 2015. We investigated immunosuppressive medication use in the two years following diagnosis, analyzed demographic and clinical characteristics, and quantified chest imaging and pulmonary function testing (PFTs) across the clinical course. Over two years of follow-up, 41% of patients were treated with prednisone. Of those, 75% tapered off their first course within 100 days, although half of those patients required recurrent therapy. Five percent of the entire cohort remained on prednisone for longer than one year, with an average daily dose of 10–20 mg. Chest imaging was associated with early prednisone use, and chest CT was associated with changes in prednisone dose. PFTs or demographics were not associated with prednisone use. Cumulative prednisone doses were significantly higher in African Americans (1,845 mg additional) and those who had a chest CT (2,015 mg additional). Overall, PFTs were less frequently obtained than chest imaging and had no significant change over disease course. The natural history of sarcoidosis varies greatly. For those requiring therapy, corticosteroid burden is high. Chest imaging drives medication dose changes as compared to PFTs, but neither outcome fully captures the entire history of disease. Prospective cohorts are needed with purposefully collected, repeated measures that include objective clinical assessments and symptoms.

Chest imaging

Clinical endpoints

Corticosteroids

Natural history

Sarcoidosis

Details

Title: Subtitle: Patterns of medication use and imaging following initial diagnosis of sarcoidosis
Creators: J. Simmering - University of Iowa
E.M. Stapleton - University of Iowa
P.M. Polgreen - University of Iowa
J. Kuntz - Kaiser Permanente
A.K. Gerke - University of Iowa
Resource Type: Journal article
Publication Details: Respiratory medicine, Vol.189, pp.106622-106622
DOI: 10.1016/j.rmed.2021.106622
PMID: 34600163
PMCID: PMC10918686
NLM abbreviation: Respir Med
ISSN: 0954-6111
eISSN: 1532-3064
Publisher: Elsevier Ltd
Grant note: DOI: 10.13039/100000038, name: U.S. Food and Drug Administration
Language: English
Date published: 11/2021
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Infectious Diseases; Health Management and Policy; Epidemiology; Pharmacy Practice and Science; Injury Prevention Research Center; Internal Medicine
Record Identifier: 9984359687702771

Metrics

16 Record Views

4 Times Cited - Web of Science