Sarcoidosis is often treated with glucocorticoids, although the use of biologics is growing. Prescribing patterns for biologics for sarcoidosis patients in U.S. rheumatology practices have never been examined. The aim of this study was to characterize the real‐world treatment of sarcoidosis and to assess practice‐level variation in prescribing patterns.

The RISE registry represents an estimated 32% of the U.S. clinical rheumatology workforce. Adult patients with ≥ two codes for sarcoidosis more than 30 days apart were included. Sarcoidosis‐specific medication use at any time, was examined during the study period. Data were analyzed at the practice level. Overall, 59.3% of patients were prescribed glucocorticoids; 24.7% received prolonged glucocorticoid therapy (≥10 mg/day for 90 days). 12.1% received a biologic or targeted synthetic disease-modifying drug (tsDMARD), most commonly TNF inhibitors. There was wide practice‐level variation among 31 practices with ≥ 30 sarcoidosis patients: biologic use ranged from 15.6% to 69.2%; infliximab represented the most common biologic prescribed.

In a large sample of U.S. rheumatology practices, 12% of patients with sarcoidosis received biologics or tsDMARD. We found high variability in biological use across practices. The effective use of long‐term glucocorticoids suggests unmet therapeutic needs in this patient population.