Antimycobacterial drugs for chronic forms of skin sarcoidosis

Sarcoidosis is a chronic granulomatous disease for the treatment of which the therapeutic options are very, very limited.

In the first simple, labeled, placebo-controlled randomized study, antimycobacterial drugs were found to reduce the diameter of the lesions and the severity of the disease in patients with chronic sarcoidosis.

The aim of this study was to assess the safety and efficacy of antimycobacterial therapy in the resolution of lesions in patients with chronic sarcoidosis.

The study involved 30 patients with sarcoidosis and clinically severe skin lesions requiring therapeutic intervention. Participants were randomized to receive a combination of ethambutol, azithromycin and rifampicin inside (CLEAR) or placebo for 8 weeks. Patients were followed during follow-up for 180 days.

An evaluation was made of the absolute variation in the diameter of the lesions and a decrease in the severity of the granulomas at the end of the treatment.

In the study group, there was an average decrease in the diameter of the lesion of -8.4 mm compared to an increase of 0.07 mm in the control group (p = 0.05). In the group receiving antimycobacterial drugs, there was a statistically significant decrease in the severity of the granulomas - for example, an average decrease of -2.9 mm in the severity of the lesion compared to a decrease of only -0, 6 mm in the placebo group (p = 0.02).

Thus, it has been shown that antimycobacterial treatment can lead to a significant reduction in the diameter of the foci in the chronic cutaneous form of sarcoidosis compared to placebo. This positive trend in the form of reduced lesion volume persisted for 180 days of the follow-up period.