Ninety patients with sarcoidosis were enrolled in a randomized trial of the effect of three months of prednisone therapy. Eighty-three patients completed treatment and were followed for at least a year. in thirty-seven patients with hilar lymphadenopathy alone on admission to the study, no significant difference between treated and control groups was noted either at the end of the treatment period or after a mean interval of 5.2 years. in forty-six patients with pulmonary infiltration, significant improvement was evident at the end of the treatment period but no differences between treated patients and controls were demonstrable after a mean interval of 5.4 years.
Subsequent relapse or progression necessitated prednisone therapy in 38 per cent of patients receiving placebo and 24 per cent of treated patients. the prognosis was significantly better in patients entering the study with hilar adenopathy alone. These observations support the views, widely but not universally held, that prednisone exerts little influence on the eventual outcome of sarcoidosis but is ameliorative in patients with pulmonary involvement.