In Search for Factors Contributing to Fibrosing Sarcoidosis: Assessment of Compliance with Clinical Guidelines
https://doi.org/10.58838/2075-1230-2025-103-3-66-78
Abstract
The objective: to compare sarcoidosis patients with complete remission to the patients who developed pulmonary fibrosis, search for causes of a different course of the disease, and assess the impact of adherence to clinical guidelines on the development of pulmonary fibrosis in sarcoidosis.
Subjects and Methods. The data of 459 patients who according to chest CT data had complete remission (373, Remission Group) or developed fibrosis (86, Fibrosis Group) were analyzed.
Results. The comparison revealed that patients in Fibrosis Group were older, the proportion of women was lower, Lefgren's syndrome at onset was less common, patients more often received anti-tuberculosis therapy, as well as inhaled glucocorticosteroids, systemic glucocorticosteroids, and systemic glucocorticosteroids with no observation period, repeated courses of systemic glucocorticosteroids, methotrexate, leflunomide, and treatment tactics were less likely to comply with clinical recommendations. Spontaneous remissions of sarcoidosis were rarely associated with the development of fibrosis. When comparing subgroups with preliminary stratification of copy pairs (20/20) of patients (initially stage II sarcoidosis, FEV1 ≥70% of normal value), there were no significant differences in gender, age, Lefgren's syndrome at the detection, concomitant pathology, smoking, frequency of SGS prescription, but the frequency of adherence to clinical recommendations was 95% in the subgroup from Remission Group and only 35% in the subgroup from Fibrosis Group.
About the Authors
A. A. Vizel
Kazan State Medical University, Russian Ministry of Health
Russian Federation
Russian Federation
Aleksandr A. Vizel, Doctor of Medical Sciences, Professor, Honored Doctor of the Republic of Tatarstan, Head of Phthisiopulmonology Department
49 Butlerova St., Kazan, 420012
Phone: +7 (843) 236-09-22
S. N. Avdeev
I.M. Sechenov First Moscow State Medical University (Sechenov University), Russian Ministry of Health; Pulmonology Research Institute by the Russian Federal Medical Biological Agency
Russian Federation
Russian Federation
Sergey N. Avdeev, Doctor of Medical Sciences, Academician of RAS, Professor, Head of Pulmonology Department, N.V. Sklifosovskiy Institute of Clinical Medicine, Head of Clinical Department
8 Bd. 2, Trubetskaya St., Moscow 119991
Phone: +7 (495) 708-35-76
I. Yu. Vizel
Kazan State Medical University, Russian Ministry of Health
Russian Federation
Russian Federation
Irina Yu. Vizel, Doctor of Medical Sciences, Associate Professor of Phthisiopulmonology Department
49 Butlerova St., Kazan, 420012
Phone: +7 (843) 236-09-22
G. R. Shakirova
Kazan State Medical University, Russian Ministry of Health; Republican Clinical Hospital, Ministry of Health of the Republic of Tatarstan
Russian Federation
Russian Federation
Gulnaz R. Shakirova, Candidate of Medical Sciences, Assistant of Phthisiopulmonology Department, Pulmonologist,Republican Clinical Hospital, Ministry of Health of the Republic of Tatarstan
49 Butlerova St., Kazan, 420012
Phone: +7 (843) 236-09-22
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Review
For citations:
Vizel A.A., Avdeev S.N., Vizel I.Yu., Shakirova G.R. In Search for Factors Contributing to Fibrosing Sarcoidosis: Assessment of Compliance with Clinical Guidelines. Tuberculosis and Lung Diseases. 2025;103(3):66-78. (In Russ.) https://doi.org/10.58838/2075-1230-2025-103-3-66-78
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