If your sarcoidosis does not cause any significant symptoms or medical problems, you may not need treatment. Instead, your doctor may decide to simply monitor your condition. As part of this monitoring process, you may have frequent office visits, follow-up chest X-rays and tests of your lung function.
To treat joint pain, acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) often are used first before corticosteroids, which tend to have more side effects. If you have signs of moderate or severe lung disease, your doctor may recommend a corticosteroid drug, such as prednisone (sold under several brand names). Corticosteroids also are used to treat sarcoidosis of the joints, skin, nerves or heart. Corticosteroid eye drops may be used for the eyes.
If corticosteroids are not effective or if they cause serious side effects, other drugs that alter or suppress the immune system may be used. Hydroxychloroquine (Plaquenil) and methotrexate (Folex, Rheumatrex) are among the more common medications in this group.
Other options include leflunomide (Arava), cyclophosphamide, or azathioprine. Newer, injectable medications, including infliximab (Remicade) or adalimumab (Humira), may be effective when other treatments have failed. In rare cases, when sarcoidosis causes life-threatening lung disease, a lung transplant may be necessary.