Sarcoidosis is a systemic disease of unknown etiology characterized by the 
development of non-caseating epitheloid granulomas. The lungs are the most 
commonly involved organ (>90% of cases), followed by the lymph nodes, the skin, 
and the eyes. Areas covered: This review summarizes current pharmacotherapy 
options and future directions for the development of new therapies. 
Glucocorticoids are the first-line therapy for sarcoidosis. For patients with 
the most severe forms of sarcoidosis (who will need glucocorticoids for long 
periods) and for those intolerant or refractory, immunosuppressive drugs are 
used as sparing agents. The management of extrathoracic sarcoidosis must be 
tailored to the specific organ or organs involved; however, there is limited 
data from controlled trials to guide the treatment of these patients. The 
emergence of biological therapies has increased the therapeutic armamentarium 
available to treat sarcoidosis, with monoclonal anti-TNF agents being the most 
promising, but their use is still limited by a lack of licensing and costs. 
Expert commentary: The treatment of sarcoidosis is still not totally 
standardized. New effective therapies are urgently needed to enable the 
reduction or replacement of long-term therapy with glucocorticoids in patients 
with sarcoidosis.