Intervention Review

Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis

  1. N Shanthi Paramothayan1,*,
  2. Toby J Lasserson2,
  3. E. Haydn Walters3

Editorial Group: Cochrane Airways Group

Published Online: 19 JUL 2006

Assessed as up-to-date: 6 APR 2006

DOI: 10.1002/14651858.CD003536.pub2

How to Cite

Paramothayan NS, Lasserson TJ, Walters EH. Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD003536. DOI: 10.1002/14651858.CD003536.pub2.

Author Information

  1. 1

    St Helier Hospital , Sutton, Surrey , UK

  2. 2

    St George's, University of London, Community Health Sciences, London, UK

  3. 3

    University of Tasmania Medical School, Discipline of Medicine, Hobart, Tasmania, Australia

*N Shanthi Paramothayan, St Helier Hospital , Sutton, Surrey , UK.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 19 JUL 2006




  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要


Immunosuppressive and cytotoxic agents have been used as both an alternative to oral corticosteroids, and as a means of maintaining a low dose of steroids in the treatment of pulmonary sarcoidosis.


To determine the efficacy of immunosuppressive and cytotoxic agents in the treatment of pulmonary sarcoidosis.

Search methods

CENTRAL, MEDLINE, EMBASE and CINAHL were searched for possible randomised trials and bibliographies were checked for other potentially relevant trials. Searches were current as of April 2006.

Selection criteria

Randomised controlled trials comparing an immunosuppressive or cytotoxic therapy with a control in patients with pulmonary sarcoidosis were included in the review.

Data collection and analysis

Two reviewers independently assessed studies for inclusion and extracted data for entry in to the RevMan 4.2. Pharmaceutical companies and study investigators were contacted for unpublished trials.

Main results

Five studies were included in the review. Trials comparing methotrexate, chloroquine, cyclosporin A and pentoxifylline were identified. No data could be combined for a meta-analysis. Data on lung function, chest x-ray scores and dyspnoea were largely inconclusive. Adverse effects were associated with methotrexate, cyclosporin A, chloroquine and pentoxifylline. In two small studies methotrexate and pentoxifylline were associated with a steroid sparing effect. In the methotrexate study this was apparent after 12 months of therapy, but no difference was observed at 6 months.

Authors' conclusions

The current body of evidence supporting the use of immunosuppressive agents and cytotoxic therapies is limited. Side-effects associated with some of the therapies were severe.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis

Sarcoidosis is a condition that can affect most of the organs in the body, including the lungs, heart, brain, bones, liver and skin. Patients who have severe disease or those who do not respond to treatment with steroids are often given powerful agents that suppress the immune system in an attempt to control the disease. However, these drugs have severe side effects. There is no evidence at the moment that the benefits of these drugs outweigh their side effects.



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要













本回顧共納入五項研究,試驗分別比較methotrexate,chloroquine,cyclosporin A 及pentoxifylline。沒有數據能供作綜合分析。有關肺功能、肺部X光片評分及呼吸困難等數據大多無法作出結論。使用methotrexate,cyclosporin A,chloroquine及pentoxifylline均伴隨不良效應。有兩項小規模的研究顯示methotrexate及pentoxifylline具有類固醇減量效應,在使用methotrexate的研究中,治療達12個月以後呈現此一效應,但在6個月時則未見到差異。





此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。