Sjögren's syndrome medical therapy
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]
Overview
Pharmacologic medical therapies for dry eyes, dry mouth, and other sicca symptom of Sjögren’s syndrome are pilocarpine, cevimeline and artificial tears.
Medical Therapy
- Pharmacologic medical therapies for dry eyes, dry mouth, and other sicca symptom of Sjögren’s syndrome include:[1][2][3][4]
- Preferred regimen (1): Pilocarpine 5 mg PO q8h
- Preferred regimen (2): Cevimeline 30 mg PO q8h
- Preferred regimen (3): Artificial tears as needed
- Pharmacologic medical therapies for organ-based disease and constitutional symptoms of Sjögren’s syndrome include:[5][6][7][8]
- Preferred regimen (1): Hydroxychloroquine 200 mg PO q24h
- Preferred regimen (2): Methotrexate 0.2 mg/kg weekly
- Preferred regimen (3): Leflunomide 20 mg/day
- Preferred regimen (4): Azathioprine 3 to 5 mg/kg once daily
- Preferred regimen (5): Sulfasalazine 30 mg PO q8h
- Preferred regimen (6): Cyclosporine 5 mg/kg/day
- Preferred regimen (7): Cyclophosphamide 50-100 mg/m²/day
- Preferred regimen (8): Rituximab 375 mg/m2 once weekly for 4 doses
References
- ↑ Wu AJ (November 2008). “Optimizing dry mouth treatment for individuals with Sjögren’s syndrome”. Rheum. Dis. Clin. North Am. 34 (4): 1001–10, x. doi:10.1016/j.rdc.2008.08.013. PMID 18984418.
- ↑ Thanou-Stavraki A, James JA (April 2008). “Primary Sjogren’s syndrome: current and prospective therapies”. Semin. Arthritis Rheum. 37 (5): 273–92. doi:10.1016/j.semarthrit.2007.06.002. PMID 17714766.
- ↑ Ramos-Casals M, Brito-Zerón P, Sisó-Almirall A, Bosch X, Tzioufas AG (May 2012). “Topical and systemic medications for the treatment of primary Sjögren’s syndrome”. Nat Rev Rheumatol. 8 (7): 399–411. doi:10.1038/nrrheum.2012.53. PMID 22549247.
- ↑ Furness S, Worthington HV, Bryan G, Birchenough S, McMillan R (December 2011). “Interventions for the management of dry mouth: topical therapies”. Cochrane Database Syst Rev (12): CD008934. doi:10.1002/14651858.CD008934.pub2. PMID 22161442.
- ↑ Nobeyama Y, Matsuzaki H, Nakagawa H (May 2014). “Annular erythema of Sjögren’s syndrome treated successfully with low-dose cyclosporine”. J. Dermatol. 41 (5): 463–4. doi:10.1111/1346-8138.12475. PMID 24801928.
- ↑ Yokota K, Shichinohe R, Hayasaka T (July 2005). “Topical tacrolimus in the treatment of annular erythema associated with Sjögren’s syndrome”. Clin. Exp. Dermatol. 30 (4): 450–1. doi:10.1111/j.1365-2230.2005.01803.x. PMID 15953102.
- ↑ Ramos-Casals M, Anaya JM, García-Carrasco M, Rosas J, Bové A, Claver G, Diaz LA, Herrero C, Font J (March 2004). “Cutaneous vasculitis in primary Sjögren syndrome: classification and clinical significance of 52 patients”. Medicine (Baltimore). 83 (2): 96–106. PMID 15028963.
- ↑ Shahin AA, El-Agha S, El-Azkalany GS (July 2014). “The effect of leflunomide on the eye dryness in secondary Sjögren’s syndrome associated with rheumatoid arthritis and in rheumatoid arthritis patients”. Clin. Rheumatol. 33 (7): 925–30. doi:10.1007/s10067-014-2548-8. PMID 24647977.
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