A39-19 Predictors of Initiating Steroid Sparing Therapy in a Multicenter Sarcoidosis Cohort

Abstract Rationale Sarcoidosis is a multisystem granulomatous disorder of unknown etiology, characterized by the formation of non-caseating granulomas, often triggered by environmental exposures in genetically susceptible individuals. Due to the heterogeneity in clinical presentation and disease course, treatment practices vary widely across the United States. This study seeks to characterize the demographic and clinical features of sarcoidosis patients initiated on steroid-sparing agents within the Southeastern Sarcoidosis Consortium (SESARC) with the aim of identifying predictors for initiating steroid sparing therapy and exploring variability across centers. Methods A retrospective chart review of 634 new sarcoidosis patients seen in 2019 across the five centers comprising SESARC was conducted. Demographic, clinical, and treatment data were extracted from electronic health records, including age, sex, race, BMI, Scadding stage, dangerous organ involvement, antisarcoidosis medications at initial visit, and those started within 1 year of their initial visit. Descriptive statistics summarized patient characteristics and treatment patterns. Pearson’s chi-square (or Fisher’s exact tests as appropriate) were used to assess associations between categorical variables and initiation of steroid-sparing agents. Finally, binary logistic regression using backward likelihood ratio elimination was used to determine significant combination of predictors for initiation of steroid sparing therapy. Results A total of 55 patients were initiated on steroid-sparing therapy within the SESARC network within 1 year of their initial visit. The median age was 42 years, 41.8% were female, and 69% identified as black. Dangerous organ involvement was present in 72.7% of patients, and 47.8% were receiving prednisone at their initial visit. Backwards stepwise selection model revealed that medical center and dangerous organ involvement were the only significant predictors of steroid sparing therapy within the first year. Conclusion While initiation of steroid sparing therapy in patients with dangerous organ involvement is consistent with recent treatment guidelines, the variability observed across SESARC institutions highlights the need for standardized criteria for initiating steroid-sparing agents to harmonize treatment approaches and ensure timely initiation of steroid-sparing therapy for high-risk patients. This abstract is funded by: None