Source: International Congress 2015 – Acute and chronic lung diseases: good clinical practice
Disease area: Interstitial lung diseases

Abstract

Chronic sarcoidosis is marked by the heterogeneity of clinical phenotypes. Some patients may enter spontaneous remission without medication, in others the disease progress despite therapy. While there is no cure for sarcoidosis, immunosuppression is often employed to control inflammation, although the clinical response is variable.Objective: to analyze patients clinical characteristics, inflammatory findings that point to those individuals who will most likely respond to treatment.Methods: in a cohort of 50, previously described MTX treated, chronic sarcoid patients (1) we compared the initial clinical status (sex, age, disease duration, smoking habits, radiological picture) and disease activity (RBC, WBC, CRP, Ca, P serum levels, proteinogramme, ddimers, fibrinogene, serum and BAL TNFa, TGFb, IL2, IL2R, IL12, IL10 levels) between MTX responders vs MTX nonresponders groups.Results:No association with patient clinical status was found. Predictors of MTX response were high serum albumins (52,8 vs 48,9, p<0,001),low serum phosphor concentration (1,74 vs 1,98; p<0,001)and basophils (% 0,49 vs 0,65, p<0,001; k/ul 0,029 vs 0,038, p<0,001). Fibrinogene level was increased in responders (18,2vs8,3 NS).Higher values of CRP (7,2vs5,5 NS), ddimers (714,5vs 445,9, NS) and the BAL IL2 concentration (91,8 vs34,6; p<0,001) were observed in nonresponders.Conclusion:Defining initial inflammatory status of potential candidates for therapy might be helpful in further therapeutic decisions and enhance prognostication.1. Goljan Geremek A. et al. Methotrexate as a single agent for treating pulmonary sarcoidosis: a single centre real-life prospective study Pneumonol Alergol Pol, 2014, 82, 518-33.


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Anna Goljan Geremek (Warsaw, Poland), Anna Goljan Geremek, Michal Bednarek, Urszula Demkow, Elzbieta Puscinska, Adam Nowinski, Dorota Gorecka. Are there any predictors of MTX response in progressive pulmonary sarcoidosis?. Eur Respir J 2015; 46: Suppl. 59, 3691

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