Sarcoidosis

Alternative Treatment 08/31/2009

Question:

I have sarcoidois and have been off prednisone since 4/09 and am experiencing severe arthritic joint pain particularly in my hands. Are there any alternative medicines available as I do not want to return to a steroid since I have had many many side affects including heart disease? Thank you

Answer:

A return of your arthritis symptoms may be a sign of reactivation of the disease elsewhere. Thus, you are advised to follow up with the doctors managing your sarcoidosis. 

Assuming that your joint symptoms are the only active problem, corticosteroids (prednisone) are generally not the preferred treatment. This class of drugs has a number of undesirable long-term side-effects. Other alternatives for treating joint pains include non-steroidal anti-inflammatory drugs (e.g., ibuprofen), hydroxychloroquine, or methotrexate (for more difficult cases). In some situations, a combination of these agents administered in low-doses is effective. This approach reduces the risk of adverse side-effects associated with using a single agent at higher doses. 

This is not a comprehensive list of treatments, and it is recommended that you follow up with your doctor to manage your disease. 

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Response by:

Elliott D Crouser, MD Associate Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine Pulmonary, Allergy, Critical Care & Sleep Medicine Department of Internal Medicine College of Medicine The Ohio State University