Safety of treatments for primary Sjögren’s syndrome

Abstract

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

Sialendoscopy enhances salivary gland function in Sjögren’s syndrome: a 6-month follow-up, randomised and controlled, single blind study

“…Systemic treatment is often ineffective and can result in major side effects 8. However, some biologic disease-modifying antirheumatic drugs have shown promise for improved efficacy with mostly mild adverse events 9. Biologicals will probably not be effective for all patients with SS, but only in subgroups of patients with SS 10…”

Editorial: Rituximab in the Treatment of Sjögren's Syndrome: Is It the Right or Wrong Drug?

“…Again, with the exception of the TRACTISS trial, fatigue was shown to be reduced in rituximab-treated patients with primary SS (2). Again, with the exception of the TRACTISS trial, fatigue was shown to be reduced in rituximab-treated patients with primary SS (2).…”

“…The Schirmer I test is not sufficiently sensitive to detect small changes in tear production. Except for the TRACTISS trial (4), positive results with regard to symptoms of oral and ocular dryness were reported in all studies of primary SS (2). This apparent recovery of corneal integrity also indicates the beneficial effect of rituximab.…”

“…In other words, should patients with primary SS who are treated with rituximab be better defined to enhance success of this promising treatment modality, given that beneficial effects have been reported at clinical, biologic, histologic, and ultrasonographic levels (2,3,5)? In other words, should patients with primary SS who are treated with rituximab be better defined to enhance success of this promising treatment modality, given that beneficial effects have been reported at clinical, biologic, histologic, and ultrasonographic levels (2,3,5)?…”

Clinical Efficacy and Safety of Total Glucosides of Paeony for Primary Sjögren’s Syndrome: A Systematic Review

“…However, there is a risk of adverse events associated with DMARD treatment. Besides, evidence for the effectiveness of DMARD therapies for pSS is limited [8]. Therefore, safer and more effective drugs need to be found.…”