minocycline and Sarcoidosis--Pulmonary

The treatment of patients with sarcoidosis remains an important part of management. The role of corticosteroids has been questioned by some, while others have reported its value even in asymptomatic patients with interstitial lung disease. Cytotoxic agents have become standard therapy for some forms of chronic disease. Newer agents that modulate the immune response have been studied. A key cytokine in chronic sarcoidosis appears to be tumor necrosis factor. Drugs that inhibit its release or block its effect have been reported as effective for sarcoidosis.

Topics: Adjuvants, Immunologic; Anti-Bacterial Agents; Azathioprine; Disease Progression; Glucocorticoids; Humans; Immunosuppressive Agents; Methotrexate; Minocycline; Respiratory Mechanics; Sarcoidosis; Sarcoidosis, Pulmonary; Tumor Necrosis Factor-alpha

To evaluate the safety and efficacy of minocycline in the treatment of sarcoidosis, a nonrandomized, open study was performed in patients with cutaneous sarcoidosis.. Twelve patients with cutaneous sarcoidosis were treated with minocycline, 200 mg/d, for a median duration of 12 months. Three patients had extracutaneous lesions at the time of the study. The median follow-up was 26 months. A clinical response was observed in 10 patients, consisting of complete responses in 8 patients and partial responses in 2 patients. A progression of skin lesions was observed in 1 patient, and lesions remained stable in another patient. Adverse effects were minimal, except in 1 patient, who developed hypersensitivity syndrome. A slight hyperpigmentation occurred in 2 patients at the site of previous lesions, which completely disappeared after minocycline use was discontinued. A relapse of skin symptoms occurred after minocycline withdrawal in 3 patients, who further received doxycycline, 200 mg/d, allowing a complete remission of lesions.. These results support that minocycline and doxycycline may be beneficial for the treatment of cutaneous sarcoidosis. Randomized controlled studies are warranted for the evaluation of the true efficacy of tetracyclines in these patients.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Arm; Female; Follow-Up Studies; Forehead; Humans; Male; Middle Aged; Minocycline; Radiography; Sarcoidosis; Sarcoidosis, Pulmonary; Skin Diseases; Treatment Outcome

Topics: Administration, Oral; Adult; Choroid Diseases; Conjunctival Diseases; Female; Humans; Kidney Diseases; Lacrimal Apparatus Diseases; Minocycline; Obesity, Morbid; Peptidyl-Dipeptidase A; Sarcoidosis; Sarcoidosis, Pulmonary; Skin Diseases; Tomography, X-Ray Computed