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Risk factors of relapse in pulmonary sarcoidosis treated with corticosteroids

  • Yi Zheng
  • Hui Wang
  • Qingqing Xu
  • Xin Yan
  • Yi Zhuang
  • Hanyi Jiang
  • Fanqing Meng
  • Yonglong Xiao
  • Hourong Cai
  • Jinghong DaiEmail author
Original Article

Abstract

Objective

To evaluate the incidence and risk factors of relapse in pulmonary sarcoidosis treated with corticosteroids.

Methods

Medical records of patients with pulmonary sarcoidosis were retrospectively reviewed. Clinical features, chest radiographs, pulmonary function tests, and treatment information were collected. The starting point was the date of diagnosis. Clinical relapse was defined as chest high-resolution computed tomography (HRCT) showing radiographic progression in combination of worsening of clinical symptoms to warrant retreatment following a decrease in dose or discontinuation of corticosteroids, without alternative causes such as infections, heart failure, or pulmonary embolism. Non-relapse was defined as remission of clinical symptoms and chest abnormalities, or clinical syndrome improvement with retention or stability of radiographic abnormalities after corticosteroids were withdrawn for at least 6 months. The primary endpoint was the occurrence of relapse.

Results

Two hundred three patients with newly biopsy-proven pulmonary sarcoidosis were enrolled over a 7-year period. Among them, 96 patients received corticosteroids therapy. Relapse occurred in 30 patients with the relapse rate yielding 30/96 (31.25%). After adjustment, multivariate analysis showed that smoking history (HR = 3.674 95% CI 1.573–8.581, P = 0.003) and increased percentages of circulating neutrophils (> 70%) (HR = 2.211, 95% CI 1.073–4.557, P = 0.032) were the significant predictors of relapse in pulmonary sarcoidosis treated with corticosteroids.

Conclusions

This study provided useful information that the relapse and associated risk factors should be taken into considerations when determining treatment strategies for patients with pulmonary sarcoidosis.

Keywords

Corticosteroid Pulmonary sarcoidosis Relapse Risk factor 

Notes

Funding information

The study was supported by the National Natural Science Foundation of China (81570058), Jiangsu Provincial Medical Talent (ZDRCA2016058), and Jiangsu Social Development Project (BE2017604).

Compliance with ethical standards

The ethics approval was acquired according to the policy of the Ethics Committee of the Affiliated Drum Tower Hospital of Nanjing University Medical School.

Disclosures

None.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  1. 1.Department of Pulmonary and Critical Care MedicineThe Affiliated Drum Tower Hospital of Nanjing University Medical SchoolNanjingChina
  2. 2.Department of PathologyThe Affiliated Drum Tower Hospital of Nanjing University Medical SchoolNanjingChina

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