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. 2024 Oct 16;79(11):1033-1039.
doi: 10.1136/thorax-2023-221309.

Pulmonary sarcoidosis: differences in lung function change over time

Michelle Sharp  1 , Kevin J Psoter  2 , Ali M Mustafa  3 , Edward S Chen  3 , Nancy W Lin  3 , Stephen C Mathai  3 , Nisha A Gilotra  4 , Michelle N Eakin  3 , Robert A Wise  3 , David R Moller  3 , Meredith C McCormack  3
Affiliations

Pulmonary sarcoidosis: differences in lung function change over time

Michelle Sharp et al. Thorax. .

Abstract

Introduction: Given the heterogeneity of sarcoidosis, predicting disease course of patients remains a challenge. Our aim was to determine whether the 3-year change in pulmonary function differed between pulmonary function phenotypes and whether there were differential longitudinal changes by race and sex.

Methods: We identified individuals seen between 2005 and 2015 with a confirmed diagnosis of sarcoidosis who had at least two pulmonary function test measurements within 3 years of entry into the cohort. For each individual, spirometry, diffusion capacity, Charlson Comorbidity Index, sarcoidosis organ involvement, diagnosis duration, tobacco use, race, sex, age and medications were recorded. We compared changes in pulmonary function by type of pulmonary function phenotype and for demographic groups.

Results: Of 291 individuals, 59% (173) were female and 54% (156) were black. Individuals with restrictive pulmonary function phenotype had significantly greater 3-year rate of decline of FVC% (forced vital capacity) predicted and FEV1% (forced expiratory volume in 1 s) predicted course when compared with normal phenotype. We identified a subset of individuals in the cohort, highest decliners, who had a median 3-year FVC decline of 156 mL. Black individuals had worse pulmonary function at entry into the cohort measured by FVC% predicted, FEV1% predicted and diffusing capacity for carbon monoxide % predicted compared with white individuals. Black individuals' pulmonary function remained stable or declined over time, whereas white individuals' pulmonary function improved over time. There were no sex differences in rate of change in any pulmonary function parameters.

Summary: We found significant differences in 3-year change in pulmonary function among pulmonary function phenotypes and races, but no difference between sexes.

Keywords: Rare lung diseases; Sarcoidosis.

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Conflict of interest statement

Competing interests: Research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health to support AMM, NWL and MS, respectively. MS has been a co-investigator on grants with aTyr Pharma, Kinevant and Novartis without support. ESC has received grant support from aTyr Pharma, Kinevant and Novartis that does not pertain to the current manuscript. NAG has consulted for Kiniksa Pharmaceutical. SCM has consulted for Janssen, United Therapeutics and Merck. RAW has received grant funding from Sanofi, Chiesi and AstraZeneca, and has consulted for Galderma, AbbVie, AstraZeneca, Boehringer-Ingelheim, Contrafect, Savara, Kamada, Bristol Myers Squibb, Pulmonx, Scene Healthcare, Beyond Air and Puretech. DRM receives royalties from Taylor & Francis Group and is chairman and chief technical officer for Sarcoidosis Diagnostic Testing. MCM has received royalties from UpToDate for authorship and editorial work and has consulting relationships with Aridis, GlaxoSmithKline, NDD Medical Technologies, MCG Diagnostics and Boehringer Ingelheim.

Figures

Figure 1:
Figure 1:
Race Difference in Lung Function Over Time in Sarcoidosis A - FVC% predicted over the 3-year period among White individuals within the cohort by pulmonary function phenotype. B - FVC% predicted over the 3-year period among Black individuals within the cohort by pulmonary function phenotype. C - FEV1% predicted over the 3-year period among White individuals within the cohort by pulmonary function phenotype. D - FEV1% predicted over the 3-year period among Black individuals within the cohort by pulmonary function phenotype E - DLCO% predicted over the 3-year period among White individuals within the cohort by pulmonary function phenotype. F - DLCO% predicted over the 3-year period among Black individuals within the cohort by pulmonary function phenotype. Note - FVC – forced vital capacity; FEV1 – forced expiratory volume over 1 second; DLCO – diffusing capacity of the lungs for carbon monoxide Multivariable linear mixed models which included pulmonary function phenotype*time interaction in addition to time since sarcoidosis diagnosis, sex, tobacco use, and medication use.
See this image and copyright information in PMC

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