Which medications in the drug class Corticosteroids are used in the treatment of Neurosarcoidosis?

Updated: Nov 13, 2018
  • Author: Gabriel Bucurescu, MD, MS; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Answer

Corticosteroids

These agents have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli and are the mainstay of treatment in neurosarcoidosis.

Oral prednisone is the corticosteroid most commonly used. When high-dose oral prednisone fails, patients may respond to methylprednisolone pulses (eg, 1 g/wk for 8 wk). Disagreement exists about the optimal dose, but doses listed here are typical. Often, high doses are required for 2-4 wk before tapering; taper may need to be continued for several months before discontinuing treatment altogether.

Prednisone

Prednisone, the most commonly used oral corticosteroid, works by altering the immune system and decreasing the inflammatory reaction that is responsible for granuloma formation in sarcoidosis. A negative tuberculin skin test is required prior to commencing high daily doses of steroids.

Prednisone may decrease inflammation by reversing increased capillary permeability and suppressing polymorphonuclear neutrophil (PMN) activity. It stabilizes lysosomal membranes and suppresses lymphocytes and antibody production. Use the lowest possible maintenance dose.


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