Biologic Therapy in the Treatment of Sjögren’s Syndrome: a Clinical Perspective
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Purpose of review
Sjögren’s syndrome (SS) is an autoimmune disease characterized by sicca symptoms, musculoskeletal pain, and systemic manifestations. Biologic therapies have been successful in the treatment of autoimmune diseases and are being studied and used more extensively in SS. In this review, we discuss the burden of illness, challenges with clinical trials, new clinical practice guidelines, biologic therapies, and novel therapies in the treatment of SS.
Trials have shown that tumor necrosis factor-alpha (TNF-α) inhibitors are not helpful for most SS patients. Rituximab has demonstrated improvement in fatigue, gland function, and disease activity in small studies of SS though larger randomized-controlled-trials have failed to reach their primary endpoints. Non-controlled studies of belimumab and abatacept have reported positive results. New clinical practice guidelines have been published to assist in the management of SS including specific recommendations regarding the use of biologic therapies.
Biologic therapies show a lot of promise in the treatment of SS. Further studies are pending and new results will likely lead to future changes in the standard of care of this complex disease.
KeywordsSjögren’s syndrome Treatment Biologic Rituximab Clinical Guidelines
Compliance with Ethical Standards
Conflict of Interest
Dr. Johr reports consulting honoraria from Kaiser Associates, L.E.K. Consulting, and KeyQuest Health, Inc. outside the submitted work and is a member of the Sjögren’s Syndrome Foundation Board of Directors.
Dr. Vivino reports personal fees and grant support from Biogen-Idec, Inc., personal fees, grant, and non-financial support from Immco Diagnostics, Inc., and personal fees from Novartis, Inc. outside the submitted work; also, former member of the Sjögren’s Syndrome Foundation Board of Directors, former Chair of SSF Medical & Scientific Advisory Board and, former Chair of the SSF Clinical Practice Guidelines Committee. Author of cited articles in this paper.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by either of the authors.
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