Effects of hydroxychloroquine on salivary flow rates and oral complaints of Sjögren patients: a prospective sample study

Çankaya, Hülya; Alpöz, Esin; Karabulut, Gonca; Güneri, Pelin; Boyacıoğlu, Hayal; Kabasakal, Yasemin

doi:10.1016/j.tripleo.2010.02.032

Cited by 27 publications

(17 citation statements)

References 29 publications

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“…This RCT study [39] also measured unstimulated salivary flow rate. The results show that there was no significant difference in the amount of saliva secreted between patients treated with HCQ and placebo, which is consistent with the result of another case series study [38]. Similarly, in terms of dry eyes, the combined results of the three studies [31, 37, 39] show that HCQ produced a slightly higher response rate than placebo, but the only RCT study showed no statistically significant difference.…”

Section: Discussionsupporting

confidence: 85%

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Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis

Wang

Zhang

Pan

et al. 2017

BMC Musculoskelet Disord

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BackgroundTo systematically review and assess the efficacy and safety of hydroxychloroquine (HCQ) for treating primary Sjogren’s syndrome (pSS).MethodsFive electronic databases (Pubmed, EMBASE, Web of science, Ovid, Cochrane Library) were searched for randomized controlled trials and retrospective or prospective studies published in English that reported the effect of HCQ on pSS. The subjective symptoms (sicca symptoms, fatigue and pain) and the objective indexes (erythrocyte sedimentation rate and Schirmer test) were assessed as main outcome measures. A meta-analysis and descriptive study on the efficacy and safety of HCQ were conducted. The estimate of the effect of HCQ treatment was expressed as a proportion together with 95% confidence interval, and plotted on a forest plot.ResultsFour trials with totals of 215 SS patients, including two randomized controlled trials, one double blind crossover trial and one retrospective open-label study, were analyzed in this review. For dry mouth and dry eyes, the effectiveness of HCQ treatment was essentially the same as placebo treatment. For fatigue, the effectiveness of HCQ was lower than placebo. The efficacy of HCQ in treating pain associated with pSS was superior to that of the placebo. There was no significant difference between HCQ-treated groups and controls in terms of Schirmer test results, but HCQ could reduce the erythrocyte sedimentation rate compare with placebo. A descriptive safety assessment showed that gastrointestinal adverse effects were the most common adverse effects associated with HCQ.ConclusionsThis systematic review showed that there is no significant difference between HCQ and placebo in the treatment of dry mouth and dry eye in pSS. Well-designed, randomized, controlled trials are needed to provide higher-quality evidence to confirm our findings, and future studies should focus on some other index or extraglandular measures, such as cutaneous manifestations, to further explore the therapeutic effect of HCQ in pSS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-017-1543-z) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 85%

“…It is commonly used to treat fatigue, arthralgia, and myalgia [22, 34–36]. However, there are also studies that have come to the conclusion that it is not an effective treatment for pSS [37, 38]. Two recently published randomized controlled trials (RCTs) suggest that HCQ has no significant effect as compared with placebo [39, 40].…”

Section: Introductionmentioning

confidence: 99%

Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis

Wang

Zhang

Pan

et al. 2017

BMC Musculoskelet Disord

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“…However, the sensitivity of the UWS flow rate with a threshold of ≤ 0.1 mL/min showed 52% of sensitivity in a previous study [4]. Median UWS flows between 0.08 and 0.16 mL/min were observed in recent cohorts of pSS patients (diagnosed according to the two most recent international classification criteria), which confirmed the relatively low proportion of pSS patients having a UWS flow rate of ≤ 0.1 mL/min [13][14][15][16].…”

Section: Introductionsupporting

confidence: 54%

Unstimulated whole saliva flow for diagnosis of primary Sjögren’s syndrome: time to revisit the threshold?

et al. 2020

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Background: Unstimulated whole saliva (UWS) flow rate is one of the ACR/EULAR 2016 criteria for primary Sjögren's syndrome (pSS). With a single threshold of ≤ 0.1 mL/min, UWS flow does not take into account the ageand sex-related physiological variations. Furthermore, it has a low sensitivity for the diagnosis of pSS (about 50%), contrary to the screening test for xerophthalmia, Schirmer's test (sensitivity of about 70%). We aimed to identify UWS thresholds allowing better performances for a screening test for pSS comparable to Schirmer's test, and considering age-and sex-related variations. Methods: A prospective cohort of 185 patients with oral and/or ocular dryness was classified into 3 groups: men, women < 50 (< 50 years old), and women ≥ 50 (≥ 50 years old). The diagnostic performances of UWS flow rate in these groups were compared in terms of sensitivity, specificity, positive and negative predictive values, and ROC curves. The identification of thresholds that optimize diagnostic performances was carried out using Youden's index. Results: The diagnostic performances of UWS flow rate varied according to age and sex. UWS had poor diagnostic performances whatever the threshold in the women ≥ 50 group. The threshold of 0.2 mL/min had a sensitivity of ≥ 70% and a specificity of ≥ 50% in both men and women < 50 groups. In the whole population and compared to the current cutoff, a threshold of 0.2 mL/min increased sensitivity (+ 19.8%) and positive (+ 2.3%) and negative (+ 7.0%) predictive values, with a better specificity (65.2%) than Schirmer's test. Conclusion: For objective assessment of xerostomia, raising the threshold of the UWS flow rate to 0.2 mL/min would optimize its screening performances for pSS.

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“…In other conditions that accompany SS, the rampant tooth decay that occurs as a consequence of the xerostomia is very difficult to manage but several recent studies have now shown that oral glandular secretions and sicca complaints can be improved with HCQ (Dawson et al 2005;Descloux et al 2009;Cankaya et al 2010).…”

Section: Sjögren's Syndromementioning

confidence: 99%

Therapy and pharmacological properties of hydroxychloroquine and chloroquine in treatment of systemic lupus erythematosus, rheumatoid arthritis and related diseases

et al. 2015

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HCQ and CQ have a good reputation for being effective and relatively safe treatments in SLE, mild-moderate RA and Sjøgren's syndrome. There is need for (a) more information on their mode of action in relation to the control of these diseases, (b) scope for developing formulations that have improved pharmacokinetic and therapeutic properties and safety, and (c) further exploring their use in drug combinations not only with other disease modifying agents but also with biologics.

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Effects of hydroxychloroquine on salivary flow rates and oral complaints of Sjögren patients: a prospective sample study

Cited by 27 publications

References 29 publications

Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis

Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis

Unstimulated whole saliva flow for diagnosis of primary Sjögren’s syndrome: time to revisit the threshold?

Therapy and pharmacological properties of hydroxychloroquine and chloroquine in treatment of systemic lupus erythematosus, rheumatoid arthritis and related diseases

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