Is there a role for the use of inhaled corticosteroids in patients with pulmonary sarcoidosis who have stage II or III disease with abnormal lung function but only mild respiratory symptoms?

There are several older studies that have tried to answer this question.

Du Bois et al., PMID 10445610: 44 stage II or III patients randomized to placebo or fluticasone 2mg/day, showed no statistically significant difference in symptom scores, PEFR, or FEV1 over 6 months (although trend towards improvement)

Alberts et al., PMID 7656936: 47 newly diagnosed stage I – III patients randomized to placebo or inhaled budesonide. Significant improvement in symptoms (using GCI) and VC found in budesonide group; no difference in chest imaging findings.

Milman et al., PMID 8077885: 29 patients randomized to inhaled budesonide 1.2mg/day or 2.0mg/day or placebo for 12 months. No difference in dyspnea, cough, spirometry in treated groups

Pietinalho et al., P...