The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis

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dc.contributor.advisorVan Zyl-Smit, Richard
dc.contributor.authorEknewir, Salaheddin
dc.date.accessioned2025-11-20T09:28:38Z
dc.date.available2025-11-20T09:28:38Z
dc.date.issued2025
dc.date.updated2025-11-20T09:25:12Z
dc.description.abstractBackground: Pulmonary sarcoidosis can lead to significant morbidity and mortality, and the use of corticosteroids is a common treatment strategy1,2. The expected response to corticosteroids with respect to lung function is highly variable and not studied in an African cohort. The primary objective of our study was to investigate the impact of corticosteroids on lung function in patients with active pulmonary sarcoidosis. Methods: We conducted a retrospective cohort study including all patients with active pulmonary sarcoidosis initiated on systemic corticosteroids documented in the Groote Schuur Hospital respiratory clinic registry. Patients with histologically proven pulmonary sarcoidosis in whom prednisone therapy was initiated were identified retrospectively from the Groote Schuur Hospital respiratory clinic registry. Data extracted from medical records included patient demographics and clinical characteristics, corticosteroid dosage, duration and recorded side effects, chest imaging, and pulmonary function testing across one year following steroid initiation. We analyzed the effect of prednisone on FVC and DLCO trajectory and reported the serial changes at 3 monthly intervals. Data is presented as mean (± SD) unless otherwise specified. Results: The study group comprised 42 patients, 30 females (71%) and 12 males (29%), with a mean age of 41.6 ± 9.8 years. The majority of patients (78.5%) were non-smokers. More than two-thirds of patients (69%) were diagnosed with Scadding II sarcoidosis. Routine lung function monitoring at 3 months showed a significant improvement in FVC with steroid therapy from 70.8(26.2) % to 77.5(25.5) % (mean change 6.3(11.3) %, p<0.001). Although not statistically significant, the FVC continued to improve numerically between month 3 (77.5%) and month 6, 79.0(23.5%). DLCO improved from 57.6(24.9) % at baseline to 61.0(33.0) % at 3 months to 68.9(28.1) % at 6 months (p<0.001) Weight changed over time with a mean (SD) increase of 8.3(7.0)kg at 9 months. Conclusions: Among patients with acute pulmonary sarcoidosis requiring immunosuppression therapy, prednisone improved FVC and DLCO, with most of the FVC effect occurring within 3 months after initiation. DLCO continued to improve to 6 months Weight gain positively correlated with cumulative prednisone dose over 9 months.
dc.identifier.apacitationEknewir, S. (2025). <i>The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/42277en_ZA
dc.identifier.chicagocitationEknewir, Salaheddin. <i>"The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2025. http://hdl.handle.net/11427/42277en_ZA
dc.identifier.citationEknewir, S. 2025. The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis. . University of Cape Town ,Faculty of Health Sciences ,Department of Medicine. http://hdl.handle.net/11427/42277en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Eknewir, Salaheddin AB - Background: Pulmonary sarcoidosis can lead to significant morbidity and mortality, and the use of corticosteroids is a common treatment strategy1,2. The expected response to corticosteroids with respect to lung function is highly variable and not studied in an African cohort. The primary objective of our study was to investigate the impact of corticosteroids on lung function in patients with active pulmonary sarcoidosis. Methods: We conducted a retrospective cohort study including all patients with active pulmonary sarcoidosis initiated on systemic corticosteroids documented in the Groote Schuur Hospital respiratory clinic registry. Patients with histologically proven pulmonary sarcoidosis in whom prednisone therapy was initiated were identified retrospectively from the Groote Schuur Hospital respiratory clinic registry. Data extracted from medical records included patient demographics and clinical characteristics, corticosteroid dosage, duration and recorded side effects, chest imaging, and pulmonary function testing across one year following steroid initiation. We analyzed the effect of prednisone on FVC and DLCO trajectory and reported the serial changes at 3 monthly intervals. Data is presented as mean (± SD) unless otherwise specified. Results: The study group comprised 42 patients, 30 females (71%) and 12 males (29%), with a mean age of 41.6 ± 9.8 years. The majority of patients (78.5%) were non-smokers. More than two-thirds of patients (69%) were diagnosed with Scadding II sarcoidosis. Routine lung function monitoring at 3 months showed a significant improvement in FVC with steroid therapy from 70.8(26.2) % to 77.5(25.5) % (mean change 6.3(11.3) %, p<0.001). Although not statistically significant, the FVC continued to improve numerically between month 3 (77.5%) and month 6, 79.0(23.5%). DLCO improved from 57.6(24.9) % at baseline to 61.0(33.0) % at 3 months to 68.9(28.1) % at 6 months (p<0.001) Weight changed over time with a mean (SD) increase of 8.3(7.0)kg at 9 months. Conclusions: Among patients with acute pulmonary sarcoidosis requiring immunosuppression therapy, prednisone improved FVC and DLCO, with most of the FVC effect occurring within 3 months after initiation. DLCO continued to improve to 6 months Weight gain positively correlated with cumulative prednisone dose over 9 months. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Lung function KW - Pulmonary sarcoidosis LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis TI - The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis UR - http://hdl.handle.net/11427/42277 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/42277
dc.identifier.vancouvercitationEknewir S. The Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis. []. University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/42277en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectLung function
dc.subjectPulmonary sarcoidosis
dc.titleThe Effect of initiating corticosteroids on lung function and symptoms in patients with active pulmonary sarcoidosis
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMasters
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