The Efficacy of Different Treatment Options in Cutaneous Sarcoidosis: A Meta-analysis of RCTs.

Cutaneous sarcoidosis is a granulomatous skin disease associated with significant quality-of-life impairment. Evidence from randomized controlled trials (RCTs) guiding systemic or targeted therapy remains limited. To assess the efficacy and safety of pharmacological therapies for cutaneous sarcoidosis in randomized placebo-controlled trials PubMed, the Cochrane Library, and ClinicalTrials.gov were searched through January 2025. Eligible studies were RCTs including adults with cutaneous sarcoidosis randomized to pharmacological therapy versus placebo. Outcomes were clinical response, quality of life, and serious adverse events (SAEs). Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated using random-effects models. Six RCTs including 156 participants were analyzedanalysed. Pharmacological therapies did not significantly improve clinical response compared with placebo (OR 2.24; 95% CI, 0.73-6.90; p=0.16). A non-significant trend toward improved quality of life was observed (OR 2.23; 95% CI, 0.87-5.73; p=0.09). No significant difference in SAEsserious adverse events was found between groups (OR 0.97; 95% CI, 0.48-1.96; p=0.93). Risk of bias ranged from moderate to high, with low statistical heterogeneity. Pharmacological add-on therapies showed no significant efficacy beyond corticosteroids but may improve quality of life. Larger, well-designed RCTs are needed.