Long-term corticosteroids in sarcoidosis carry well-known harms: weight gain, diabetes, bone loss and infection. The lowest effective dose is the goal.
Agree a written taper schedule at the start, with clear triggers for slowing it, such as worsening symptoms, spirometry or imaging. Protect bone and monitor glucose throughout.
- Write down a taper schedule when steroids are started.
- Define in advance what would prompt slowing or reversing the taper.
- Check glucose and blood pressure, and protect bone health on prolonged courses.
- Review whether a steroid-sparing agent is needed when the taper repeatedly stalls.
Why it matters
Steroid doses in sarcoidosis tend to stay where they started unless someone plans their reduction.
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