Sarcoidosis is a systemic inflammatory disease in which clusters of immune cells form granulomas — small nodules of inflamed tissue — most commonly in the lungs and lymph nodes but potentially in any organ, including the heart, eyes, skin, and nervous system. The cause remains unknown but likely involves an exaggerated immune response to an environmental trigger in genetically susceptible individuals. Most cases resolve spontaneously, but a significant minority develop chronic or progressive disease.
What's actually going on in research
Corticosteroids are the mainstay of treatment when intervention is needed, but their long-term use causes significant side effects. Methotrexate and azathioprine are commonly used steroid-sparing agents. Newer biologic agents — particularly anti-TNF therapies (infliximab, adalimumab) — have shown benefit in refractory cases and are being tested in controlled trials. Research is also exploring JAK inhibitors, IL-12/23 blockade, and rituximab for specific manifestations such as neurosarcoidosis and cardiac sarcoidosis.
Anti-TNF biologics
Infliximab and adalimumab are now used in refractory sarcoidosis and are in controlled trials evaluating their ability to reduce granulomatous inflammation and spare corticosteroids long-term.
JAK inhibitors
JAK inhibitors are in early trials for chronic pulmonary sarcoidosis and neurosarcoidosis, given their broad anti-inflammatory effects and potential steroid-sparing role.
Cardiac sarcoidosis trials
Dedicated trials are studying optimal immunosuppression strategies in cardiac sarcoidosis — a life-threatening manifestation — where evidence guiding treatment has historically been limited.
What to know before you search
Eligibility typically requires biopsy-confirmed sarcoidosis, active or progressive disease, and often failed response to corticosteroids or steroid-sparing therapy.
What types of trials are currently open
- Biologic therapy trials — Testing anti-TNF agents, JAK inhibitors, and IL-12/23 blockers in refractory pulmonary and extrapulmonary sarcoidosis.
- Cardiac sarcoidosis trials — Evaluating immunosuppression strategies and device therapy in sarcoidosis-related heart disease and arrhythmia.
- Neurosarcoidosis trials — Studying biologics and steroid-sparing agents for central and peripheral nervous system sarcoidosis.
- Steroid-sparing trials — Comparing methotrexate, mycophenolate, and newer agents as corticosteroid-sparing maintenance therapies.
- Biomarker and monitoring studies — Identifying serum and imaging biomarkers to guide treatment decisions and predict relapse.
Recently added Sarcoidosis trials
Corticosteroid Tapering in Sarcoidosis
Sarcoidosis is an inflammatory condition affecting many different parts of the body but most commonly the lungs. It is not known what causes sarcoidosis. In some patients no treatment is needed but in other patients long term treatment may be required. One of the main medications used to manage this condition is corticosteroids. This medication has been shown to be very effective at reducing inflammation in this condition and many patients often remain on it for months to years. Unfortunately, there are many negative long-term side effects of corticosteroid use. This includes an increased risk of developing diabetes, reduced bone density, weight gain, high blood pressure and low muscle mass. Currently there are no guidelines for how steroids should be weaned in patients who have stable sarcoidosis. The investigators aim to undertake a study at the Royal Brompton Hospital which will be assessing two different steroid tapering regimens which will be allocated to participants in a randomised manner. This will be the first study to directly evaluate different steroid weaning regimens in sarcoidosis patients. The main aim of this study is to determine how many participants can reduce their prednisolone dose to less than 50% from their baseline dose. Additionally, the investigators will be recording how many participants require an increase in dose or an additional medication whilst on the prednisolone weaning regimen. The investigators will also see the tolerability of steroid withdrawal and assess for any symptoms of steroid withdrawal. In a small subset of participants the investigators will assess for any changes in body composition and muscle strength using bioelectrical impedance analysis and isometric muscle testing.
Immune Cells Role in Lung Cancer and Their Use in Anticancer Immunotherapies and Inflammatory Lung Disease
This study aims to better understand the role of immune system cells in lung diseases such as lung cancer, sarcoidosis, and chronic obstructive pulmonary disease (COPD). The investigators are studying how these immune cells can sometimes help the body defend itself, but in other cases may contribute to cancer growth or long-term lung inflammation. Although recent treatments like immunotherapy have improved cancer care, only a small proportion of patients currently benefit from these therapies. One goal of this research is to understand why some patients do not respond or develop resistance to treatment. The knowledge gained from this study may help researchers develop more effective and personalized treatments for people with lung diseases in the future.
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