Pulmonary sarcoidosis: a multicentre initiative

Short Communication - Research and Reports in Pulmonology (2021) Volume 2, Issue 2

Sarcoidosis is a chronic systemic disease of unknown aetiology, characterised histologically by

granulomatous inflammation. Existing treatment options include either no medication or a mix of firstline,

second-line and third-line medication with trade-offs between treating inflammation and quality

of life (QoL). A chronic disease course requires long-term treatment with corticosteroids, cytotoxics

and other agents that can have a serious impact on the quality of life. Significant grey areas exist in

approaches to treatment and thus how care is delivered across different countries and centres. Little

knowledge is available regarding outcomes of delivered care in relation to the various treatment options.

Therefore, there is a need for standardisation of core outcomes to ensure high-value care delivery for

all patients with sarcoidosis globally. Patients suffering from chronic diseases have persistent needs

and therefore need ongoing healthcare. Accordingly, patients with complex chronic conditions, such as

sarcoidosis, are also the costliest patients, and costs increase with the number of chronic conditions. In

patients with sarcoidosis, it has been confirmed they have higher rates of comorbidity and complexity

compared with a matched control group (matched for age and gender). Furthermore, it was found

that the main comorbidities were pulmonary, liver, autoimmune and neoplastic disease in patients

with sarcoidosis compared with controls. It was estimated that commercial payers incurred US$19 714

annually on healthcare costs spent per patient with sarcoidosis in the USA, with outpatient visits and

inpatient admissions as the two main cost drivers. Globally, healthcare providers are driven by similar

goals: to improve patient experiences and healthcare outcomes, to become more efficient and to reduce

the costs as well as to innovate the way care is provided. As addressed by Porter, value-based healthcare

(VBHC) could be a guiding principle in achieving these multiple goals. In particular, transparently

sharing treatment outcomes of routine clinical care can help hospitals to learn from each other and

improve patient value, defined as outcomes over costs. Sarcoidosis often affects young and middle-aged

adults. Patients suffer from a broad range of non-specific symptoms, with high variability in the degree

of inflammation as well as organs affected. In more than 90% of the cases, sarcoidosis affects the lungs.

Spontaneous remissions occur in approximately two-thirds of the patients, but the disease course is

chronic in 10%–30% of the patients. Incidence and prevalence rates reported in the literature are highly

variable. The prevalence varies over geographical regions as well as ethnic groups, with the highest

sarcoidosis prevalence reported in the Nordic countries and in individuals of African descent. For this

study, we aimed to specifically develop a standard set of outcome measures for patients with pulmonary

sarcoidosis.

Author(s): Rennie Medina,