Advances in the treatment of ocular dryness associated with Sjögren׳s syndrome

Ciurtin, Coziana; Ostas, Anca; Cojocaru, Viorica Mădălina; Walsh, Stephen B.; Isenberg, David

doi:10.1016/j.semarthrit.2015.06.007

Cited by 21 publications

(10 citation statements)

References 54 publications

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“…Blood analysis of anti-SSA antibody, anti-SSB antibody, rheumatoid factor, and anti-ANA antibody is recommended. 5 The meibomian gland, one of the specialized sebaceous glands, is significantly more damaged in SS patients (57.9%) than in non-SS patients (18.5%; P ¼ 0.005). 19 In addition, the lid margin, located at the juncture between the mucosal membrane and the skin of eyelid, is frequently affected in SSrelated dry eye patients.…”

Section: Sjögren's Syndrome-related Dry Eyementioning

confidence: 99%

See 1 more Smart Citation

Sjögren's Syndrome, Non-Sjögren's Syndrome, and Graft-Versus-Host Disease Related Dry Eye

Ogawa

2018

Invest. Ophthalmol. Vis. Sci.

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I have reviewed available literature on dry eye related to Sjögren's syndrome (SS), non-Sjögren's syndrome (non-SS), and graft-versus-host disease (GVHD) to examine aqueous tear deficient dry eye as a subtype of dry eye. This section will focus on clinical studies regarding those subtypes of dry eye. I searched the PubMed database from 1990-2017 for discussion of clinical features, diagnostic criteria, and risk factors of SS, non-SS, and GVHD-related dry eye. In addition, therapeutic options for each subtype of dry eye are described. Although the clinical presentations of SS and chronic graft-versus-host disease (cGVHD) are similar, ocular surface fibrotic changes are characteristic of ocular GVHD but not SS-or non-SS-related dry eye. Recently, diagnostic criteria for each disease have been proposed and include the American College of Rheumatology/European League Against Rheumatism (ACR-EULAR) for SS and the International Chronic Ocular GVHD consensus criteria. Although there has been gradual progress, there are currently no specific therapies and few approved treatment options for these intractable diseases, including SS and GVHD. As judged by the findings, these subtypes of dry eye are different clinical entities from simple dry eye. Therefore, novel therapies, specific to these subtypes of dry eye, may be required in the future.

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Section: Sjögren's Syndrome-related Dry Eyementioning

confidence: 99%

“…4 The prevalence of SS patients is reported to be 0.05% in Japan 4 and 0.07% in the United States. 5 Diagnostic criteria for Sjögren's syndrome were proposed by the ACR-EULAR in 2016. These diagnostic criteria may become the gold standard for diagnosing Sjögren's syndrome.…”

Section: Sjögren's Syndrome-related Dry Eyementioning

confidence: 99%

Sjögren's Syndrome, Non-Sjögren's Syndrome, and Graft-Versus-Host Disease Related Dry Eye

Ogawa

2018

Invest. Ophthalmol. Vis. Sci.

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“…Zur nächtlichen Therapie können Augensalben angewandt werden. Cyclosporin A-Augentropfen werden bei einigen Patienten mit unzureichendem Ansprechen erfolgreich eingesetzt [45]. In seltenen Fällen schwerer refraktärer Sicca-Symptomatik, bzw.…”

Section: Krankheitsmanifestation Allgemein-und Therapiemaßnahmen Bemeunclassified

Das Sjögren-Syndrom

et al. 2017

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ZusammenfassungDas Sjögren-Syndrom ist eine chronische Autoimmunerkrankung mit Beteiligung der Tränen- und Speicheldrüsen. Durch lymphozytäre Infiltration und sekundäre Destruktion des exokrinen Drüsengewebes kommt es zur Sicca-Symptomatik. Es handelt sich um eine der 3 häufigsten Autoimmunerkrankungen mit einer Prävalenz von 0,03–2,1%, abhängig von Alters- und Populationsgruppen sowie der angewandten Diagnostik-Kriterien, und betrifft deutlich häufiger Frauen (ca. 10:1) 1 2 3. Neben der charakteristischen Sicca-Symptomatik leiden viele Patienten unter systemischen Manifestationen wie z. B. Arthralgien, seltener Hautvaskulitis, interstitieller Lungenerkrankung oder Nierenbeteiligung.Nicht-steroidale Antirheumatika, Kortikosteroide und Immunsuppressiva werden zur Therapie dieser Komplikationen angewandt während die Sicca-Symptomatik meist lokal-symptomatisch behandelt wird. Das Risiko der Entwicklung eines malignen Lymphoms ist beim Sjögren-Syndrom erhöht. Ein Großteil der Patienten leidet außerdem unter einer ausgeprägten Abgeschlagenheit (Fatigue) 4, die das subjektiv schwerwiegendste Symptom darstellen kann. Die Prävalenz von depressiven Störungen ist ebenfalls erhöht 5. Auch wenn neue therapeutische Angriffspunkte und B-Zell-gerichtete Therapien, die sich derzeit in klinischer Testung befinden, auf eine Verbesserung der Behandlungsmöglichkeiten hoffen lassen, bleibt die Heterogenität des Krankheitsbildes und der Symptome eine Herausforderung in Klinik und Forschung.

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“…[9] If the effect of tear replacement is inadequate, topical immunomodulatory agents such as cyclosporine and corticosteroids, and systemic stimulation of tear production can be added to the treatment.…”

Section: Ocular Manifestationsmentioning

confidence: 99%

Safety of treatments for primary Sjögren’s syndrome

Nimwegen

Moerman

Smitt

et al. 2016

Expert Opinion on Drug Safety

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Introduction: Primary Sjögren's syndrome (pSS) is a disabling auto-immune disease, affecting exocrine glands and several organs. Areas covered:In this review we analyze the safety of therapies used in pSS. Symptomatic treatment is widely applied due to the good supportive effect and good safety profile. Systemic stimulation of tears and saliva can be successful in pSS. However, cumbersome adverse events can influence the tolerability of this therapy. Evidence for the effectiveness of synthetic DMARDs therapies in pSS is limited, while there is a risk of adverse events. Several studies on biologic DMARD treatment of pSS patients have shown promising efficacy and safety results. Expert opinion: The safety of symptomatic treatment of pSS is very good. However, systemic therapy is necessary to achieve long-term relieve and prevention of organ-damage. Synthetic DMARDs have not shown much efficacy in earlier studies, and their benefits do not weigh up to the possible harms, while biologic DMARDs show promising results regarding efficacy and cause mostly mild adverse events. Many questions remain unanswered regarding safety of DMARDs in pSS. There is a need for well designed studies, in which safety should be evaluated in a uniform manner to be able to compare the results between studies.ARTICLE HISTORY

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Advances in the treatment of ocular dryness associated with Sjögren׳s syndrome

Cited by 21 publications

References 54 publications

Sjögren's Syndrome, Non-Sjögren's Syndrome, and Graft-Versus-Host Disease Related Dry Eye

Sjögren's Syndrome, Non-Sjögren's Syndrome, and Graft-Versus-Host Disease Related Dry Eye

Das Sjögren-Syndrom

Safety of treatments for primary Sjögren’s syndrome

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