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The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis

Background: Pulmonary sarcoidosis can lead to significant morbidity and mortality, and the use of corticosteroids is a common treatment strategy1,2. The expected response to corticosteroids with respect to lung function is highly variable and not studied in an African cohort. The primary objective o...

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Main Author: Eknewir, Salaheddin
Other Authors: Van Zyl-Smit, Richard
Format: Thesis
Language:English
English
Published: Department of Medicine 2025
Subjects:
Lung function
Pulmonary sarcoidosis
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access_status_str Open Access
author Eknewir, Salaheddin
author2 Van Zyl-Smit, Richard
author_browse Eknewir, Salaheddin
Van Zyl-Smit, Richard
author_facet Van Zyl-Smit, Richard
Eknewir, Salaheddin
author_sort Eknewir, Salaheddin
collection Thesis
description Background: Pulmonary sarcoidosis can lead to significant morbidity and mortality, and the use of corticosteroids is a common treatment strategy1,2. The expected response to corticosteroids with respect to lung function is highly variable and not studied in an African cohort. The primary objective of our study was to investigate the impact of corticosteroids on lung function in patients with active pulmonary sarcoidosis. Methods: We conducted a retrospective cohort study including all patients with active pulmonary sarcoidosis initiated on systemic corticosteroids documented in the Groote Schuur Hospital respiratory clinic registry. Patients with histologically proven pulmonary sarcoidosis in whom prednisone therapy was initiated were identified retrospectively from the Groote Schuur Hospital respiratory clinic registry. Data extracted from medical records included patient demographics and clinical characteristics, corticosteroid dosage, duration and recorded side effects, chest imaging, and pulmonary function testing across one year following steroid initiation. We analyzed the effect of prednisone on FVC and DLCO trajectory and reported the serial changes at 3 monthly intervals. Data is presented as mean (± SD) unless otherwise specified. Results: The study group comprised 42 patients, 30 females (71%) and 12 males (29%), with a mean age of 41.6 ± 9.8 years. The majority of patients (78.5%) were non-smokers. More than two-thirds of patients (69%) were diagnosed with Scadding II sarcoidosis. Routine lung function monitoring at 3 months showed a significant improvement in FVC with steroid therapy from 70.8(26.2) % to 77.5(25.5) % (mean change 6.3(11.3) %, p<0.001). Although not statistically significant, the FVC continued to improve numerically between month 3 (77.5%) and month 6, 79.0(23.5%). DLCO improved from 57.6(24.9) % at baseline to 61.0(33.0) % at 3 months to 68.9(28.1) % at 6 months (p<0.001) Weight changed over time with a mean (SD) increase of 8.3(7.0)kg at 9 months. Conclusions: Among patients with acute pulmonary sarcoidosis requiring immunosuppression therapy, prednisone improved FVC and DLCO, with most of the FVC effect occurring within 3 months after initiation. DLCO continued to improve to 6 months Weight gain positively correlated with cumulative prednisone dose over 9 months.
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institution University of Cape Town (South Africa)
language English
eng
last_indexed 2026-06-10T12:33:35.758Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2025
publishDateRange 2025
publishDateSort 2025
publisher Department of Medicine
publisherStr Department of Medicine
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/42277 The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis Eknewir, Salaheddin Van Zyl-Smit, Richard Lung function Pulmonary sarcoidosis Background: Pulmonary sarcoidosis can lead to significant morbidity and mortality, and the use of corticosteroids is a common treatment strategy1,2. The expected response to corticosteroids with respect to lung function is highly variable and not studied in an African cohort. The primary objective of our study was to investigate the impact of corticosteroids on lung function in patients with active pulmonary sarcoidosis. Methods: We conducted a retrospective cohort study including all patients with active pulmonary sarcoidosis initiated on systemic corticosteroids documented in the Groote Schuur Hospital respiratory clinic registry. Patients with histologically proven pulmonary sarcoidosis in whom prednisone therapy was initiated were identified retrospectively from the Groote Schuur Hospital respiratory clinic registry. Data extracted from medical records included patient demographics and clinical characteristics, corticosteroid dosage, duration and recorded side effects, chest imaging, and pulmonary function testing across one year following steroid initiation. We analyzed the effect of prednisone on FVC and DLCO trajectory and reported the serial changes at 3 monthly intervals. Data is presented as mean (± SD) unless otherwise specified. Results: The study group comprised 42 patients, 30 females (71%) and 12 males (29%), with a mean age of 41.6 ± 9.8 years. The majority of patients (78.5%) were non-smokers. More than two-thirds of patients (69%) were diagnosed with Scadding II sarcoidosis. Routine lung function monitoring at 3 months showed a significant improvement in FVC with steroid therapy from 70.8(26.2) % to 77.5(25.5) % (mean change 6.3(11.3) %, p<0.001). Although not statistically significant, the FVC continued to improve numerically between month 3 (77.5%) and month 6, 79.0(23.5%). DLCO improved from 57.6(24.9) % at baseline to 61.0(33.0) % at 3 months to 68.9(28.1) % at 6 months (p<0.001) Weight changed over time with a mean (SD) increase of 8.3(7.0)kg at 9 months. Conclusions: Among patients with acute pulmonary sarcoidosis requiring immunosuppression therapy, prednisone improved FVC and DLCO, with most of the FVC effect occurring within 3 months after initiation. DLCO continued to improve to 6 months Weight gain positively correlated with cumulative prednisone dose over 9 months. 2025-11-20T09:28:38Z 2025-11-20T09:28:38Z 2025 2025-11-20T09:25:12Z Thesis / Dissertation Masters Masters http://hdl.handle.net/11427/42277 en eng application/pdf Department of Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Lung function
Pulmonary sarcoidosis
Eknewir, Salaheddin
The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis
thesis_degree_str Master's
title The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis
title_full The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis
title_fullStr The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis
title_full_unstemmed The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis
title_short The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis
title_sort effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis
topic Lung function
Pulmonary sarcoidosis
url http://hdl.handle.net/11427/42277
work_keys_str_mv AT eknewirsalaheddin theeffectofinitiatingcorticosteroidsonlungfunctionandsymptomsinpatientswithactivepulmonarysarcoidosis
AT eknewirsalaheddin effectofinitiatingcorticosteroidsonlungfunctionandsymptomsinpatientswithactivepulmonarysarcoidosis

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