# Clinical Pharmacology in Sarcoidosis: How to Use and Monitor Sarcoidosis Medications

## TL;DR

This paper reviews how to use and monitor medications for sarcoidosis, focusing on alternatives to glucocorticoids due to their side effects.

## Contribution

The paper provides a practical clinical guide on sarcoidosis pharmacotherapy, including drug monitoring and special situations.

## Key findings

- Glucocorticoids are effective but have significant side effects requiring alternatives.
- Corticosteroid-sparing therapies are often needed in chronic sarcoidosis cases.
- The paper outlines drug dosing, monitoring, and special considerations from recent guidelines.

## Abstract

When sarcoidosis needs treatment, pharmacotherapy is usually required. Although glucocorticoids work reliably and relatively quickly for sarcoidosis, these drugs are associated with numerous significant side effects. Such side effects are common in sarcoidosis patients, as the disease frequently has a chronic course and glucocorticoid treatment courses are often prolonged. For these reasons, corticosteroid-sparing and corticosteroid-replacing therapies are often required for sarcoidosis. Unfortunately, many healthcare providers who care for sarcoidosis patients are not familiar with the use of these agents. In this manuscript, we provide a review of the pharmacotherapy of sarcoidosis. We discuss the mechanism of action, dosing, side-effect profile, approach to monitoring and patient counselling concerning glucocorticoids, and the common alternative drugs recommended for use in the recent European Respiratory Society (Lausanne, Switzerland) Sarcoidosis Treatment Guidelines. We also discuss the use of these agents in special situations including hepatic insufficiency, renal insufficiency, pregnancy, breastfeeding, vaccination, and drug–drug interactions. It is hoped that this manuscript will provide valuable practical guidance to clinicians who care for sarcoidosis patients.