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Introduction Within Interstitial Lung Disease management there is increasing recognition of glucocorticoid toxicity. Recent literature suggests that initial Methotrexate (MTX) treatment may be noninferior to Prednisolone in Pulmonary Sarcoidosis. We aim to examine the impact different treatments have on Patient Reported Outcomes.Methods 116 participants underwent clinical assessment, selected blood testing, plain CXR evaluation and Quality of Life (QoL) measurement including the Kings Sarcoidosis Questionnaire (KSQ) and EQ-5D-5L during enrolment in the TEM Sarcoidosis Project (IRAS 309950). They were followed for 1 year with repeat assessment and investigation. Participants were stratified dependent on treatment; none, single agent Prednisolone, MTX (± additional treatment), Hydroxychloroquine (HCQ), and anti-TNF.Results At enrolment mean age was 59.6 (SD 11.3), 66% were Male, with median disease duration 7.3 years (IQR 3.4–11.9), 42% did not require treatment. There were no significant differences in terms of age of diagnosis, duration of disease, gender and burden of disease (Scadding stage) across all participants. Within the treatment group 31% were treated with single agent Prednisolone (n 26), 10% were treated with MTX (n 12), 11% were treated with HCQ (n 13), and 3% received anti-TNF treatment. QoL measures were globally better in treatment naïve participants. Within the treatment group there were no significant differences between Prednisolone and Methotrexate in terms of age at diagnosis, gender and burden of disease. The Prednisolone group trended towards a longer duration of disease (10.6 v 8.7 p 0.452), whereas the MTX group had higher BMI (28.2 v 34.3 p 0.016). There were no significant differences in QoL measurements between these groups at enrolment. Figure 1 presents Follow up data at one year, available for 47 participants. MTX compared favourably with Prednisolone with greater improvements in KSQ domains and a smaller decline in Visual Analogue Scale.Abstract P21 Figure 1Change in King’s Sarcoidosis Questionnaire Score, and EQ-5D-5L at Enrolment and 1 YearConclusion Raised BMI in the MTX group suggests preferential use as a steroid sparing agent, possibly to limit hyperglycaemic complications. The results need interpreted with caution as most participants were cotreated with Prednisolone or HCQ, nevertheless the data is favourable and gives reassurance of a positive impact.