期刊
SEMINARS IN ARTHRITIS AND RHEUMATISM
卷 37, 期 5, 页码 273-292出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.semarthrit.2007.06.002
关键词
primary Sjogren syndrome; sicca syndrome; dry eye; dry mouth; treatment; biologics; anti-TNF-alpha; rituximab; lymphoma
类别
资金
- NCRR NIH HHS [RR20143, RR15577] Funding Source: Medline
- NIAID NIH HHS [AI31584] Funding Source: Medline
- NIAMS NIH HHS [AR49084, P30 AR053483, AR48045, AR45084, AR48940] Funding Source: Medline
- NATIONAL CENTER FOR RESEARCH RESOURCES [P20RR020143, P20RR015577] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [R01AI031584] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES [R03AR045084, P01AR049084, P50AR048940, P30AR053483, R01AR048045] Funding Source: NIH RePORTER
Objective: To summarize data on existing and experimental therapies for primary Sjogren's syndrome (pSS), referring both to sicca syndrome and to other systemic disease manifestations. Methods: Relevant English and non-English articles acquired through Medline were reviewed. Results: pSS usually has a benign clinical course, centered on sicca features and general musculoskeletal manifestations, and is managed symptomatically. However, a subset of patients develops more severe extraglandular disease that warrants close monitoring and aggressive treatment. For dry eyes and mouth, nonpharmacologic measures to preserve secretions, and tear and saliva substitutes, offer some symptomatic relief. Muscarinic agonists and topical cyclosporine yield well-documented improvement in ocular sicca features. Although traditional antirheumatic drugs are used empirically for polyarthritis and other Sjogren's symptoms, their efficacy in pSS overall and as disease-modifying agents is limited. For the potential severe, nonexocrine manifestations complicating pSS, standard high-dose immunosuppression is used. Among the biologic agents already examined in pSS, those targeting tumor necrosis factor (TNF)-alpha failed to demonstrate significant benefit. Nonetheless, rituximab and other B-cell-depleting therapies appear promising. Conclusions: Treatment of pSS patients with severe extraglandular disease should differ from that of patients with predominantly sicca features and/or general muscoloskeletal manifestations. pSS treatment is mainly symptomatic, primarily directed against sicca complaints. The traditional anti-rheumatic agents show limited efficacy in the systemic process and use of systemic TNF-alpha inhibitors has been very disappointing. B cell depleting treatments and other newer biologic therapies appear more promising. (C) 2008 Elsevier Inc. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据