Pulmonary Sarcoidosis: A Prospective Evaluation of Glucocorticoid Therapy

Glucocorticoid therapy has long been advocated for treatment of pulmonary dysfunction in sarcoidosis. No controlled prospective study in current medical literature establishes the efficacy of such therapy. Four years ago a prospective study using alternate-case treatment with prednisone was initiated in patients with pulmonary function abnormalities due to sarcoidosis. The two groups were similar in sex, age, race, degree of pulmonary dysfunction, and duration of disease. Patients were evaluated with complete spirometric studies, single-breath carbon monoxide diffusing capacity, and arterial blood gases. Serial studies of 1 to 2 years in duration were available for each patient and showed no difference between the treated and untreated groups. Improvement or deterioration in pulmonary function of individual patients in the treated group was matched by similar changes in the controls. Data from this study failed to prove that glucocorticoid therapy produced any beneficial change in pulmonary function.