SAT0624 Incidence and baseline characteristics of relapse or exacerbation in patients with pulmonary sarcoidosis: a single centre long-term observational cohort study
Authors: O. Murata, A. Kudo, K. Suzuki
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Sarcoidosis is a systemic granulomatous disease that can affect multiple organs. Lung involvement is particularly common, occurring in more than 90% of patients.<sup>1</sup> However, spontaneous remission of pulmonary sarcoidosis is often observed within 2 years.<sup>2</sup>Factors reported to indicate a poor prognosis in pulmonary sarcoidosis include chest radiographic stage, skin involvement, age over 40 years and smoking history.<sup>3, 4</sup> To date, however, no study has comprehensively described factors of relapse and exacerbation and characteristics of untreated patients with favourable outcomes over a long-term period of more than 2 years. <h3>Objectives</h3> The aim of study was to identify the incidence and baseline characteristics of relapse and exacerbation in patients with pulmonary sarcoidosis over a long-term period. <h3>Methods</h3> One hundred- and three patients who visited our division of Hachinohe Red Cross Hospital between January 2007 and December 2016 and were clinically diagnosed as having pulmonary sarcoidosis were enrolled. The incidence and characteristics of relapse or exacerbation were prospectively calculated and statistically analysed using clinical, laboratory and imaging data collected from medical records. <h3>Results</h3> Of 103 patients, 79% were women and mean age at diagnosis was 50.1±16.4 years. Mean observation period was 9.8±8.6 years. The number of patients with previously reported short-term prognostic factors ware as follows: chest radiographic stage (Stage 0, n=7; Stage I, n=32; Stage II, n=36; Stage III, n=18; Stage IV, n=10), skin involvement (n=9), age over 40 years old (n=73), and smoking history (n=38). Overall relapse or exacerbation was 22.3% (n=23) and mean period to relapse or exacerbation was 8.7±8.3 years. We then analysed the 69 patients who were observed for more than 5 years, and identified relapse or exacerbation within 5 years in 9 patients. Comparison of characteristics at diagnosis between the relapse or exacerbation group and spontaneous group showed that the relapse or exarcerbation group had a significantly elevated frequency of bilateral hilar lymphadenopathy, disease duration, ocular involvement, cardiac involvement, and oral glucocorticoid use at diagnosis (p=0.014, 0.027, 0.019, 0.035, and 0.0043, respectively). On stratification, the number of risk factors was positively and significantly associated with the cumulative ratio of relapse or exacerbation (p=0.048). <h3>Conclusions</h3> Our long-term observational cohort study newly identified the incidence and baseline characteristics of relapse or exacerbation in patients with pulmonary sarcoidosis over a long-term period. Scoring the number of the factors at baseline may facilitate the prediction of relapse or exacerbation. <h3>References</h3> [1] Br. J. Dis. Chest1976;70:206–210. [2] Dan. Bull. Med1982;29:27–32. [3] Br. Med. J1961;2:1165–1172. [4] Chest2006;130:1851–6. <h3>Disclosure of Interest</h3> None declared