A position paper discusses evolving corticosteroid strategies for sarcoidosis, noting a shift in therapeutic paradigms for steroid use. The text highlights interest in targeted molecular approaches, particularly mTOR pathway inhibitors, which have seen some success in sarcoidosis treatment. It also emphasizes the need to elucidate the precise mechanisms by which steroids exert effects in sarcoidosis, despite decades of pragmatic use spanning over 70 years. Uncertainty is acknowledged regarding the exact steroid action and the broader applicability of mTOR-targeted therapies. No new clinical outcomes or practice recommendations are provided in the source.
We read with interest the Position Paper by Athol U Wells and colleagues concerning the paradigm shift in corticosteroid therapy for sarcoidosis.1 The search for specific targets, such as those concerning the mTOR pathway, has become widespread over the past decade, resulting in the successful use of mTOR inhibitors in sarcoidosis treatment. Similar efforts to improve understanding of the precise mechanisms by which steroids act in sarcoidosis should be made with regard to steroid responsiveness, despite it being an older treatment that has been used pragmatically for over 70 years.