World Workshop on Oral Medicine VII: Immunobiologics for salivary gland disease in Sjögren's syndrome: A systematic review

Abstract

Objective This systematic review evaluated the efficacy of immunobiologics for the management of oral disease in Sjögren's syndrome (SS). Materials and Methods MEDLINE®, Embase, Scopus, and the Cochrane Library were searched for evidence on the use of immunobiologics for management of glandular disease in SS. Primary outcomes were xerostomia and salivary gland dysfunction, assessed via visual analogue scales, disease‐specific scales for SS, measurement of salivary flow, ultrasound data, and quality of life measures. Results Seventeen studies (11 randomized controlled trials and 6 observational studies) met inclusion criteria. Rituximab showed efficacy in improving salivary gland function but not xerostomia. Abatacept showed promise in improving both xerostomia and salivary flow. Belimumab exhibited long‐term improvement of salivary flow and subjective measures. The novel agent CFZ533 improved both disease activity and patient‐reported indexes. Conclusions There is strong evidence pointing to the efficacy of rituximab in the management of oral disease in SS. Future controlled trials may elucidate the efficacy of belimumab and abatacept. The new drug CFZ533 is a promising alternative for the management of SS and its salivary gland involvement. In considering these agents, the promise of efficacy must be balanced against the harmful effects associated with biologic agents.

RORγt antagonist improves Sjögren's syndrome‐like sialadenitis through downregulation of CD25

“…Recently, some biologics such as rituximab, abatacept, belimumab, and anti‐CD40 monoclonal antibody have been reported to improve salivary gland disease of SS in a systematic review (Gueiros et al, ). In comparison with these biologic agents, RORγt antagonist could be a novel alternative treatment strategy by oral administration for SS, if its effectiveness and safety are confirmed in the future studies.…”

A Novel Proposal of Salivary Lymphocyte Detection and Phenotyping in Patients Affected by Sjogren’s Syndrome

“…The use of immunobiologics in SS patients is the less studied area. We suppose that parotid saliva immunophenotyping could be used for monitoring of patients treated with immunobiologics [44].…”

Progress in the pathogenesis of thyroid-associated ophthalmopathy and new drug development

“…[ 22 23 ] CFZ533 is a monoclonal antibody against CD40, which can inhibit the activation of B-cells and has been used in the treatment of myasthenia gravis and Sjogren's syndrome. [ 24 25 ] Furthermore, CFZ533 is currently approved for the treatment of GD (NCT02713256). We speculate that these drugs are expected to be used in TAO treatment in the near future.…”