When corticosteroid therapy is insufficient or not tolerated, upper respiratory tract sarcoidosis requires escalation to a steroid-sparing regimen. This protocol outlines the structured approach for that clinical situation.
This protocol applies when an initial corticosteroid course has not achieved adequate disease control, or when corticosteroid toxicity limits continued use. In these cases, the addition of a steroid-sparing agent is the indicated next step.
The protocol involves the addition of a steroid-sparing immunomodulatory agent. Several options from this class are addressed in the full regimen — the selection, sequence, and monitoring considerations are contained within the complete protocol.
These agents typically require up to 6 months before demonstrating effectiveness and are effective in approximately two-thirds of patients. The full protocol specifies how to assess response and when to reassess management.