A modern view of the treatment of Sjogren’s disease


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Abstract

The article examines the features of the pathogenesis of Sjogren’s disease and modern therapeutic approaches. The evidence base of both synthetic immunosuppressants and modern genetically engineered biological drugs is discussed in detail. Possible reasons for the insufficient evidence base, as well as difficulties in organizing randomized controlled trials in Sjogren’s disease are analyzed.

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About the authors

A. V Torgashina

V.A. Nasonova Research Institute of Rheumatology

Email: anna.torgashina@gmail.com

References

  1. Goules A.V., Tziofas A.G: Primary Sjogren's syndrome: Clinical phenotypes, outcome and the development of biomarkers. Autoimmun Rev. 2016;15:695-703. doi: 10.1007/s12026-016-8844-4.
  2. Barbosa E.C., Jessica Bruna Correa Lindoso, de Oliveira Conde N.C., et al. Oral manifestations and histopathology of minor salivary gland from patients with Sjogren's Syndrome and its diagnosis in a public health system. Rev Bras Odontol. 201673(4):297-304. doi: 10.18363/rbo. v73n4.p.297.
  3. Bordal O, Norheim K.B., R0dahl E, et al. Primary Sjogren's syndrome and the eye. Surv Ophthalmol. 2020;65(2): 119-32. Doi: 10.1016/j. survophthal.2019.10.004.
  4. Goules A.V, Kapsogeorgou E.K., Tziofas A.G. Insight into pathogenesis of Sjogren's syndrome: Dissection on autoimmune infiltrates and epithelial cells. Clin Immunol. 2017;182:30-40. doi: 10.1016/j.clim.2017.03.007.
  5. Katsiougiannis S., Tenta R., Skopouli F.N. Autoimmune epithelitis (Sjogren's syndrome); the impact of metabolic status of glandular epithelial cells on auto-immunogenicity. J Autoimmun. 2019;104:102335. Doi:10.1016/j. jaut.2019.102335.
  6. Skopouli F.N, Dafni U., loannidis J.P, Moutsopoulos H.M. Clinical evolution, and morbidity and mortality of primary Sjogren's syndrome. Semin Arthr Rheum. 2000;29:296-304. doi: 10.1016/ s0049-0 1 72(00)80016-5.
  7. Btochowiak K., Sokalski J. Labial salivary gland biopsy in the diagnosis of Sjogren's syndrome. Eur J Clin Exp Med. 2019;17(2):162-68. doi: 10.15584/ejcem.2019.2.10.
  8. Argyropoulou O.D., Pezoulas V., Chatzis L., et al. Cryoglobulinemic vasculitis in primary Sjogren's Syndrome: Clinical presentation, association with lymphoma and comparison with Hepatitis C-related disease. Semin Arthr Rheum. 2020;50(5):846-53. doi: 10.1016/j.semarthrit.2020.07.013.
  9. Sun R., Medeiros L.J., Young K.H. Diagnostic and predictive biomarkers for lymphoma diagnosis and treatment in the era of precision medicine. Mod Pathol. 2016;29(10):1118-42. Doi: 10.1038/ modpathol.2016.92.
  10. Ioannidis J.P, Vassiliou V.A., Moutsopoulos H.M. Long-term risk of mortality and lymphoproliferative disease and predictive classification of primary Sjogren's syndrome. Arthr Rheum. 2002;46:741-47. doi: 10.1002/art.10221.
  11. Lverenz D.L., St. Clair E.W. Recent advances in the search for a targeted immunomodulatory therapy for primary Sjogren's syndrome [version 1; peer review: 2 approved] F1000. Res. 2019, 8. (F1000 Faculty Rev.):1532. doi: 10.12688/ f1000reseatch.19842.1.
  12. Сафонова Т.Н., Васильев В.И., Лихванцева В.Г. Синдром Шегрена: Руководство для врачей. Под ред. В.Г. Лихванцевой. М., 2013. 600 с.
  13. Torgashina A., Rodionova E., Safonova T., et al. Efficacy of prolonged maintenance monotherapy with rituximab in patients with primary Sjogren's syndrome: three-year follow-up. Ann Rheum Dis. 2018;77(Suppl. 2). doi: 10.1136/annrheumdis-2018-eular.5718.
  14. Cankaya H., Alpoz E., Karabulut G., et al. Effects of hydroxychloroquine on salivary flow rates and oral complaints of Sjogren patients: a prospective sample study. Oral Surg Oral Med Oral Pathol. Oral Radiol. Endod. 2010;110:62-7. Doi: 10.1016/j. tripleo.2010.02.032.
  15. Tishler M., Yaron I., Shirazi I., Yaron M. Hydroxychloroquine treatment for primary Sjogren's syndrome: its effect on salivary and serum inflammatory markers. Ann Rheum Dis. 1999;58:253-56. doi: 10.1136/ard.58.4.253.
  16. Kruize A., Hene R., Kallenberg C., et al. Hydroxychloroquine treatment for primary Sjogren's syndrome: a two year double blind cross over trial. Ann Rheum Dis. 1993;52:360-4. doi: 10.1136/ard.52.5.360.
  17. Gottenberg J.-E, Ravaud P, Puechal X., et al. Effects of hydroxychloroquine on symptomatic improvement in primary Sjogren syndrome the JOQUER randomized clinical trial. JAMA. 2014;312:249-58. Doi: 10.1001/ jama.2014.7682.
  18. Romro V.C, Talarico R., Scir C.A., et al. Sjogren's syndrome: state of the art on clinical practice guidelines. RMD. Open. 2018;0:e000789. doi: 10.1136/rmdopen-2018-000789.
  19. Price E.J., Rauz S., Tappuni A.R., et al. The British Society for Rheumatology guideline for the management of adults with primary Sjogren’s Syndrome. Rheumatol. (Oxford). 2017;56(10):e24-48. Doi: 10.1093/ rheumatology/kex166.
  20. Rogers S., Williams C., Roman G. Myelopathy in Sjogren’s syndrome: role of non-steroidal immunosuppressants. Drugs. 2004;64:123-32. doi: 10.2165/00003495-200464020-00001.
  21. Misterska-Skora M., Sebastian A., Dziefiel P., Sebastian M, Wiland P. Inclusion body myositis associated with Sjogren's syndrome. Rheumatol Int. 2013;33:3083-86. doi: 10.1007/s00296-012-2556-4.
  22. Skopouli F., Jagiello P., Moutsopoulos H. Methotrexate in primary Sjogren's syndrome. Clin Exp Rheumatol. 1996;14:555-58.
  23. Hwang J., Yang T., Lee J., et al. Severe pulmonary hypertension in primary Sjogren's syndrome. Korean Circ J. 2013;43(7):504. Doi:10.4070/ kcj.2013.43.7.504.
  24. Darrieutort-Laffite C., Andre V., Hayem G., et al. Sjogren's syndrome complicated by interstitial cystitis: a case series and literature review. J Bone Spine. 2015;82:245-50. doi: 10.1016/j.jbspin. 2014.12.007.
  25. Deheinzelin D., Capelozzi V.L., Kairalla R.A., et al. Interstitial lung disease in primary Sjogren's syndrome. Clinical-pathological evaluation and response to treatment. Am J Respir Crit Care Med. 1996;154:794-99. Doi: 10.1164/ ajrccm.154.3.8810621.
  26. Kaufman I., Schwartz D., Caspi D., Paran D. Sjogren's syndrome - not just Sicca: renal involvement in Sjogren's syndrome. Scand J Rheumatol. 2008;37:213-18. doi: 10.1080/03 009 740 701867323.
  27. Hermisson M, Klein R., Schmidt F., Weller M., Kuker W. Myelopathy in primary Sjogren's syndrome: diagnostic and therapeutic aspects. Acta Neurol Scand. 2002. doi: 10.1034/j.1600-0404.2002.01167.x.
  28. Yeoman C., Franklin C. The treatment of Sjogren's disease in NZB/NZW F1 hybrid mice with azathioprine: a two-stage study. Clin Exp Rheumatol. 1994;12:49-53.
  29. Price E, Rigby S., Clancy U, Venables PA. Double blind placebo controlled trial of azathioprine in the treatment of primary Sjogren’s syndrome. J Rheumatol. 1998;25:896-99.
  30. Drosos A., Skopouli F., Galanopoulo V., et al. Cyclosporin A. Therapy in patients with primary Sjogren's syndrome: results at one year. Scan J Rheumatol. 1986;61(Suppl.):246-49.
  31. Sall K., Stevenson O., Mundorf T., Reis B. Two multicenter, randomized studies of the efficacy and safety of cyclosporine ophtalmic emulsion in moderate to severe dry eye disease. Ophtalmol. 2005;112:1790-94. doi: 10.1016/s0161-6420(99)00176-1.
  32. Van Woerkom J.M.Kruize A.A., Geenen R., et al. Safety and efficacy of leflunomide in primary Sjogren's syndrome: a phase II pilot study. Ann Rheum Dis. 2007;66:1026-32. Doi: 10.1136/ ard.2006.060905.
  33. Bikker A., van Woerkom J.-M, Kruize A.A., et al. Clinical efficacy of leflunomide in primary Sjogren's syndrome is associated with regulation of T-cell activity and upregulation of IL-7 receptor α expression. Ann Rheum Dis. 2012;71:1934-41. doi: 10.1136/annrheumdis-2011-201026.
  34. Fox PC., Datiles M, Atkinson J.C., et al. Prednisone and piroxicam for treatment of primary Sjogren's syndrome. Clin Exp Rheumatol. 1993;11:149-56.
  35. Miyawaki S., Nishiyama S., Matoba K. Efficacy of low-dose prednisolone maintenance for saliva production and serological abnormalities in patients with primary Sjogren’s syndrome. Intern Med. 1999;38:938-43. doi: 10.2169/ internalmedicine.38.938.
  36. Carsons S.E., Vivino F.B., Parke A., et al. Treatment Guidelines for Rheumatologic Manifestations of Sjogren’s Syndrome: Use of Biologic Agents, Management of Fatigue, and Inflammatory Musculoskeletal Pain. Arthr Care Res. (Hoboken). 2017;69(4):517-27. doi: 10.1002/acr.22968.
  37. Blvarez-Rivasa N., Sang-Parkb H., del Campoc PD., et al. Efficacy of Belimumab in Primary Sjogren's Syndrome: A Systematic Review. Reumatol Clin. 2020;22;S1699-258X(20)30076-0. doi: 10.1016/j.reuma.2020.03.003.
  38. Mavragani C.P, Moutsopoulos H.M. Sjogren’s syndrome: Old and new therapeutic targets. J Autoimmun. 2020;110:102364. Doi:10.1016/j. jaut.2019.102364.
  39. Gottenberg J.E., Cinquetti G., Larroche C., et al. Efficacy of rituximab in systemic manifestations of primary Sjogren's syndrome: results in 78 patients of the AutoImmune and Rituximab registry. Ann Rheum Dis. 2013;72(6):1026-31. doi: 10.1136/annrheumdis-2012-202293.
  40. Dass S., Bowman S.J., Vital E.M., et al. Reduction of fatigue in Sjo'gren syndrome with rituximab: results of a randomised, double-blind, placebo-controlled pilot study. Ann Rheum Dis. 2008;67:1541-44. doi: 10.1136/ard.2007.083865.
  41. Meijer J.M., Meiners PM., Vissink A., et al. Effectiveness of Rituximab Treatment in Primary Sjogren's Syndrome. A Randomized, DoubleBlind, Placebo-Controlled Trial. Arthr Rheum. 2010;62(4):960-68. doi: 10.1002/art.27314.
  42. Devauchelle-Pensec V., Mariette X., Jousse-Joulin S., et al. Treatment of Primary Sjo'gren Syndrome With Rituximab. A Randomized Trial. Ann Intern Med. 2014;160:233-42. doi: 10.7326/M13-1085.
  43. Bowman S.J., Everett C.C., O’Dwyer J.L., et al. Randomized controlled trial of rituximab and cost-effectiveness analysis in treating fatigue and oral dryness in primary Sjogren's syndrome. Arthr Rheum. 2017;69(7):1440-50. Doi: 10.1002/ art.40093.
  44. Adatia F.A., Michaeli-Cohen A., Naor J., et al. Correlation between corneal sensitivity, subjective dry eye symptoms and corneal staining in Sjogren's syndrome. Canadian journal of ophthalmology. J Canad d'ophtalmol. 2004;39(7):767-71. doi: 10.1016/s0008-4182(04)80071-1.
  45. Aure M.H., Arany S., Ovitt C.E. Salivary Glands: Stem Cells, Self-duplication, or Both? J Dent Res. 2015;94(11):1502-507. doi: 10.1177/0022034515599770.

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