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Drug-induced comorbidities in patients with sarcoidosis

Sarcoidosis is a chronic multisystemic inflammatory disease of unknown aetiology with a wide range of highly variable clinical manifestations and unpredictable disease course. Sarcoidosis patients may present with specific organ-related symptoms involving functional impairments, and less specific sy...

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Autores principales: Drent, Marjolein, Jessurun, Naomi T., Wijnen, Petal A., Bekers, Otto, Bast, Aalt
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9451917/
https://www.ncbi.nlm.nih.gov/pubmed/35855576
http://dx.doi.org/10.1097/MCP.0000000000000889
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author Drent, Marjolein
Jessurun, Naomi T.
Wijnen, Petal A.
Bekers, Otto
Bast, Aalt
author_facet Drent, Marjolein
Jessurun, Naomi T.
Wijnen, Petal A.
Bekers, Otto
Bast, Aalt
author_sort Drent, Marjolein
collection PubMed
description Sarcoidosis is a chronic multisystemic inflammatory disease of unknown aetiology with a wide range of highly variable clinical manifestations and unpredictable disease course. Sarcoidosis patients may present with specific organ-related symptoms involving functional impairments, and less specific symptoms. The decision whether and when to treat a sarcoidosis patient with pharmacotherapy depends on two major factors: risk of organ failure and/or death and impairment of quality of life. This decision is complex and not standardized. RECENT FINDINGS: Glucocorticoids (GCs) are recommended as initial treatment, when needed. Subsequent GC-sparing alternatives frequently follow. Comorbidities or adverse drug reactions (ADRs) from drugs used in sarcoidosis treatment are sometimes very hard to differentiate from symptoms associated with the disease itself, which may cause diagnostic dilemmas. An ideal approach to minimalize ADRs would involve genetic screening prior to prescribing certain ‘high-risk drugs’ and therapeutic drug monitoring during treatment. Pharmacogenomic testing aims to guide appropriate selection of medicines, with the potential of reducing unnecessary polypharmacy while improving clinical outcomes. SUMMARY: A multidisciplinary approach to the management of sarcoidosis may avoid unnecessary ADRs. It is important to consider the possibility of drug-induced damage in sarcoidosis, especially if the clinical situation deteriorates after the introduction of a particular drug.
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spelling pubmed-94519172022-09-13 Drug-induced comorbidities in patients with sarcoidosis Drent, Marjolein Jessurun, Naomi T. Wijnen, Petal A. Bekers, Otto Bast, Aalt Curr Opin Pulm Med SARCOIDOSIS: Edited by Ogugua Ndili Obi and Mareye Voortman Sarcoidosis is a chronic multisystemic inflammatory disease of unknown aetiology with a wide range of highly variable clinical manifestations and unpredictable disease course. Sarcoidosis patients may present with specific organ-related symptoms involving functional impairments, and less specific symptoms. The decision whether and when to treat a sarcoidosis patient with pharmacotherapy depends on two major factors: risk of organ failure and/or death and impairment of quality of life. This decision is complex and not standardized. RECENT FINDINGS: Glucocorticoids (GCs) are recommended as initial treatment, when needed. Subsequent GC-sparing alternatives frequently follow. Comorbidities or adverse drug reactions (ADRs) from drugs used in sarcoidosis treatment are sometimes very hard to differentiate from symptoms associated with the disease itself, which may cause diagnostic dilemmas. An ideal approach to minimalize ADRs would involve genetic screening prior to prescribing certain ‘high-risk drugs’ and therapeutic drug monitoring during treatment. Pharmacogenomic testing aims to guide appropriate selection of medicines, with the potential of reducing unnecessary polypharmacy while improving clinical outcomes. SUMMARY: A multidisciplinary approach to the management of sarcoidosis may avoid unnecessary ADRs. It is important to consider the possibility of drug-induced damage in sarcoidosis, especially if the clinical situation deteriorates after the introduction of a particular drug. Lippincott Williams & Wilkins 2022-09 2022-07-18 /pmc/articles/PMC9451917/ /pubmed/35855576 http://dx.doi.org/10.1097/MCP.0000000000000889 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an-open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle SARCOIDOSIS: Edited by Ogugua Ndili Obi and Mareye Voortman
Drent, Marjolein
Jessurun, Naomi T.
Wijnen, Petal A.
Bekers, Otto
Bast, Aalt
Drug-induced comorbidities in patients with sarcoidosis
title Drug-induced comorbidities in patients with sarcoidosis
title_full Drug-induced comorbidities in patients with sarcoidosis
title_fullStr Drug-induced comorbidities in patients with sarcoidosis
title_full_unstemmed Drug-induced comorbidities in patients with sarcoidosis
title_short Drug-induced comorbidities in patients with sarcoidosis
title_sort drug-induced comorbidities in patients with sarcoidosis
topic SARCOIDOSIS: Edited by Ogugua Ndili Obi and Mareye Voortman
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9451917/
https://www.ncbi.nlm.nih.gov/pubmed/35855576
http://dx.doi.org/10.1097/MCP.0000000000000889
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