TRIP

Use of fluticasone in acute symptomatic pulmonary sarcoidosis.

Sarcoidosis, Vasculitis, and Diffuse Lung Diseases, 2002

Bob.Baughman@uc.edu BACKGROUND: Inhaled corticosteroids have been used with variable success in sarcoidosis.
METHODS: Twenty-two patients at five institutions who had been given an initial dose of oral corticosteroids within the prior four weeks were enrolled in a randomized double blind trial of inhaled fluticasone.
An algorithm for the dosage of prednisone including rules for reducing dose was developed and applied at all centers.
There was no significant difference in the improvement of vital capacity or average daily dose of prednisone for the fluticasone versus placebo.
Eight of ten patients taking fluticasone had improvement in cough, while only 6 of 11 patients on placebo had improved cough despite taking oral corticosteroids (p = 0.36, N.S.).
The algorithm for decreasing corticosteroid dosage was exactly applied in over 80% of patient visits and oral corticosteroids were used throughout most of the year of treatment.
Patients registered higher complaints regarding increased appetite and polyuria when on ten mg or more prednisone a day.
CONCLUSION: A standard approach to tapering oral corticosteroids was followed in over 80% of patient visits.
Oral corticosteroids were associated with significant complaints, while inhaled corticosteroids were well tolerated.