CHEST 2023 On Demand Pass-Sarcoidosis: Advanced-Level Care

Video Transcription

Video Summary

Good morning everyone. This session is about advanced sarcoidosis, beyond steroids. The session starts with a discussion on the options for patients with end-stage or advanced sarcoidosis. Tofacitinib and Rituximab are mentioned as potential fourth-line agents for pulmonary sarcoidosis, while Cyclophosphamide is highlighted as an important fourth-line option, especially for neurosarcoidosis. The use of repository corticotropin injection is also discussed for its steroid sparing effect. The session then moves on to the topic of quality of life in sarcoidosis. It is mentioned that quality of life is a multidimensional construct that captures the impact of symptom burden, disease severity, treatment side effects, and healthcare interactions on a patient's well-being. Fatigue is identified as one of the main determinants of reduced quality of life in sarcoidosis, and it is suggested that fatigue assessment should be done at each visit. Various interventions to improve quality of life are mentioned, including optimizing disease control, providing disease education, and offering physical and psychological interventions such as exercise and mindfulness training. The session concludes with a discussion on lung transplantation for sarcoidosis. The indications for referral to a transplant center are discussed, including pulmonary fibrosis, progressive decline in pulmonary function, and radiological progression. The outcomes of lung transplantation in sarcoidosis are described, and it is highlighted that sarcoidosis patients have similar long-term survival rates post-transplant compared to other lung diseases. However, recurrence of granulomas in the lung allograft can occur in up to 50% of patients. The session recommends early referral and a multidisciplinary approach for the management of advanced sarcoidosis and highlights the importance of optimizing disease control and addressing patient quality of life in the treatment plan.

Meta Tag

Category Diffuse Lung Disease

Session ID 2004

Speaker Hakim Ali

Speaker Marc Judson

Speaker Ogugua Obi

Speaker Oksana Shlobin

Track Diffuse Lung Disease

Keywords

advanced sarcoidosis

Tofacitinib

Rituximab

Cyclophosphamide

neurosarcoidosis

repository corticotropin injection

quality of life

fatigue assessment

lung transplantation

optimizing disease control