This clinical trial is focused on studying the effectiveness of two medications, methotrexate and prednisone, as treatments for pulmonary sarcoidosis. Pulmonary sarcoidosis is a condition where small clusters of inflammatory cells, called granulomas, form in the lungs, which can affect breathing. The purpose of the study is to compare how well these two medications work as the first treatment option for this condition.

Participants in the study will be randomly assigned to receive either methotrexate or prednisone. Methotrexate is a medication that works by interfering with the growth of certain cells, while prednisone is a type of corticosteroid that helps reduce inflammation in the body. Both medications will be taken in tablet form by mouth. The study will last for a period of 24 weeks, during which the effects of the medications on lung function and overall health will be monitored.

Throughout the study, participants will have regular check-ups to assess their lung function and monitor any changes. The main focus will be on measuring the change in lung capacity, specifically the forced vital capacity, which is a measure of how much air a person can exhale after taking a deep breath. Additionally, other health markers, known as biomarkers, will be evaluated to provide further insights into the effectiveness and tolerability of the treatments.