Comparing two ways of lowering prednisolone in people with sarcoidosis
Compares a standard and a fast prednisolone taper in adults with sarcoidosis.
Key facts
- Who runs it
- Royal Brompton & Harefield NHS Foundation Trust
- Where
- United Kingdom1 site in 1 countryChoose a country to see its sites
- Trial code
- Registry title
- Corticosteroid Tapering in Sarcoidosis
- Status
- Recruiting
- People taking part
- 100 people, planned
- Started
- 19 Mar 2026
- Expected to end
- 18 Oct 2027
- Type of study
- Interventional, 2 groupsOne group gets an existing treatment, for comparison.
- Treatments tested
- Standard prednisolone taper
- Fast prednisolone taper
- Record updated
- 27 March 2026
Who can take part
AI summary
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults with stable sarcoidosis who take a low daily dose of prednisolone. It compares two ways of slowly lowering the steroid dose.
- Age
- Over 18 years old
- Sex
- All sexes can join
- Disease stage
- Sarcoidosis confirmed by a tissue test and/or a team of specialists. The disease must have been stable for more than 6 months, with no flares or dose increases.
- Earlier treatment
- Must have taken prednisolone 5-10mg/day for more than 6 months. People may or may not be on a second-line medicine. People who have ever used infliximab cannot join.
Main reasons for not taking part
- Sarcoidosis of the heart or nervous system
- Advanced lung sarcoidosis: composite physiological index (CPI) > 40 or high blood pressure in the lungs
- A flare or dose increase in the past 6 months
- Known adrenal insufficiency (the adrenal glands make too little hormone)
- Pregnancy or breastfeeding
The registry criteria, word for word
Show all 12 criteriaShow less
Who can take part
- Confirmed sarcoidosis by: (a) Histological diagnosis and/or (b) Multidisciplinary Team (MDT) diagnosis
- Prednisolone 5-10mg/day for > 6 months
- Clinically stable disease for > 6 months (no flares or dose escalation)
- On or off second-line agent
- > 18 years old
- Written informed consent provided
Who cannot take part
- Previous or current infliximab use
- Cardiac or neurosarcoidosis
- Advanced pulmonary sarcoidosis defined as either: (a) composite physiological index (CPI) > 40 (b) pulmonary hypertension
- Known adrenal insufficiency
- Active sarcoidosis flare or dose escalation in the past 6 months
- Pregnancy or breastfeeding
This trial has no sites in United States.
It has sites in one country. Choose a country to see its sites.
About the trial
What the trial wants to find out
Sarcoidosis is an inflammatory condition affecting many different parts of the body but most commonly the lungs. It is not known what causes sarcoidosis. In some patients no treatment is needed but in other patients long term treatment may be required.
Read full original descriptionShow less
One of the main medications used to manage this condition is corticosteroids. This medication has been shown to be very effective at reducing inflammation in this condition and many patients often remain on it for months to years.
Unfortunately, there are many negative long-term side effects of corticosteroid use. This includes an increased risk of developing diabetes, reduced bone density, weight gain, high blood pressure and low muscle mass. Currently there are no guidelines for how steroids should be weaned in patients who have stable sarcoidosis.
The investigators aim to undertake a study at the Royal Brompton Hospital which will be assessing two different steroid tapering regimens which will be allocated to participants in a randomised manner. This will be the first study to directly evaluate different steroid weaning regimens in sarcoidosis patients.
The main aim of this study is to determine how many participants can reduce their prednisolone dose to less than 50% from their baseline dose. Additionally, the investigators will be recording how many participants require an increase in dose or an additional medication whilst on the prednisolone weaning regimen. The investigators will also see the tolerability of steroid withdrawal and assess for any symptoms of steroid withdrawal. In a small subset of participants the investigators will assess for any changes in body composition and muscle strength using bioelectrical impedance analysis and isometric muscle testing.
The 2 groups in the trial
- Standard prednisolone taperExisting treatment, for comparison
If initial dose of prednisolone \> 5mg/day then dose will be reduced by 2.5mg/day (round to nearest feasible dose) every 4 weeks until reaching 5mg/day. From 5mg/day to reduce by 1mg/day every 6 weeks until 3mg/day. At 3mg/day a serum cortisol will be measured after 2 weeks. If cortisol \> 25nmol/L, then continue with the Meeran prednisolone taper protocol which is reducing by 1mg every 7 days.
- Fast prednisolone taperExisting treatment, for comparison
If initial prednisolone dose \> 5mg/day then reduce by 2.5mg/day (round to nearest feasible dose) every 4 weeks until reaching 5mg/day. From 5mg/day to reduce by 1mg every 2 weeks until 3mg/day. At 3mg/day then measure serum cortisol after 2 weeks. If cortisol \> 25nmol/L then continue to taper by 1mg every 2 weeks. In this arm, patients will contacted over the phone every 2 weeks to provide support with the tapering regimen.
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorData and sources
- Registry record
- Listed on ClinicalTrials.gov.
- Official title
- Corticosteroid Tapering in Sarcoidosis
- Plain-language title
- Comparing two ways of lowering prednisolone in people with sarcoidosisGenerated from the registry record. The registry title is the official one.
- AI summary
- From the trial's eligibility criteria. Read by machine on 14 November 2026.
- Record updated
- 27 March 2026