BTS Clinical Statement on pulmonary sarcoidosis

In an era in which medical practice is increasingly determined by evidence-based guidelines, it must be acknowledged from the outset that current evidence in sarcoidosis, especially with regard to treatment, is weak. [...]a number of the conclusions in this Statement are based on expert opinion and accumulated clinical experience. [...]a great many patients do not need to be treated: the broad indications for initiating therapy are (1) a high risk of mortality or disability due to major organ involvement; and (2) unacceptable loss of quality of life. While higher dose treatment regimens may be required in high-risk disease, a highly flexible patient-centred approach is essential when treatment is introduced solely for quality of life reasons. [...]it is important to note that in a few areas of diagnosis and management where there was a non-unanimous consensus among the statement authors, this is clearly indicated. All patients should be encouraged to complete an inventory of quality of life measures and, as part of this, clinicians should emphasise the concept of ‘self-care’, that is, a deliberate activity that sarcoidosis patients undertake to look after their physical, mental or emotional well-being.