OBJECTIVES: To describe the treatment patterns by type of sarcoidosis diagnosis in a real-world claims database.

METHODS: Adult sarcoidosis patients treated with corticosteroids, methotrexate, or other medications (azathioprine, leflunomide, mycophenolate mofetil, infliximab, adalimumab, rituximab, hydroxychloroquine) between January 1, 2018, and June 30, 2023, were identified in CHRONOS, a linked open claims, closed claims, and social determinants of health database of US patients. Newly diagnosed (ICD-10-CM: D86.0-D86.9) patients had at least one month of continuous enrollment before the first diagnosis (index) in the closed claims and at least one treatment from the closed or open claims. Kaplan-Meier curves measured the median event-free probably (MEFP) from index to dis-enrollment in the closed claims. Curves were stratified by index diagnosis type (i.e., pulmonary, cutaneous, lymph node, and cardiac sarcoidosis) and first medication category. All study variables were defined by ICD-10-CM, HCPCS, and NDC codes.

RESULTS: Sarcoidosis patients (n=30,126) were 51.6 (SD: 9.9) years old on average at index and 53.7% female. At index, 66.7% of patients had pulmonary, 8.8% cutaneous, and 4.0% cardiac sarcoidosis. The MEFP was 703 days for pulmonary, 467 days for cutaneous, and 248 days for cardiac sarcoidosis (p<0.001). The MEFP was 752 days among patients first treated with a corticosteroid, 164 days among patients treated with methotrexate, and 188 days among patients treated with other medications (p<0.001). Corticosteroids and methotrexate were the first treatments for 81.7% and 7.7% of patients, respectively. Of patients first treated with a corticosteroid, 97.1% received no other treatment, while 96.6% first treated with methotrexate eventually received a steroid. Other treatments varied.

CONCLUSIONS: This analysis of treated sarcoidosis patients from a real-world hybrid claims database found corticosteroids were most often the first-line option. The timing of treatment initiation differed by sarcoidosis diagnosis and medication category, indicating severity and other underlying conditions may influence clinician decision-making.