Chloroquine in the treatment of sarcoidosis: A report from the Research Committee of the Bristish Tuberculosis Association

Abstract

Summary A double-blind trial was undertaken of the effect of chloroquine on pulmonary sarcoidosis. Eligible patients had lung shadowing of at least six months' duration and had not been treated with corticosteroids. Fifty seven patients from many centres were allocated treatment at random with inert tablets or chloroquine sulphate 600 mg. daily for 8 weeks and 400 mg. daily for 8 weeks. Assessments were made at 1, 2, 4, 6 and 12 months. Five patients were excluded from the analysis for various reasons. Compared with the chloroquine group, the control group contained more older women and more patients with histological or Kveim test support for the diagnosis. The control group also contained more patients with lesions which were considered to be only partly reversible. Radiographic assessments by independent observers showed that there was a significant improvement in the chloroquine group compared with the control group at four and six months. These findings were supported by improvement in dyspnoea and ventilatory tests. Detailed analysis showed that the differences could not be attributed to the disparity in ages and other factors between the groups. After six months there was some deterioration in the chloroquine group and some spontaneous improvement in the control group, so that there was no significant difference between them at 12 months. The effect of chloroquine is therefore believed to be suppressive rather than curative. The side effects are recorded. The toxic effects of chloroquine are described in detail so that a rational assessment can be made of the risks of treatment.