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. 2019 Jun;25 Suppl 1(Suppl 1):102-110.
doi: 10.1111/odi.13062.

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

Luiz A Gueiros  1 , Katherine France  2 , Rachael Posey  3 , Jacqueline W Mays  4 , Barbara Carey  5 , Thomas P Sollecito  2 , Jane Setterfield  5 , Sook Bin Woo  6 , Donna Culton  7 , Aimee S Payne  8 , Giovanni Lodi  9 , Martin S Greenberg  2 , Scott De Rossi  10
Affiliations

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

Luiz A Gueiros et al. Oral Dis. 2019 Jun.

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.

Keywords: Sjogren's syndrome; biologic agents; salivary flow; xerostomia.

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Figures

Figure 1.
Figure 1.
Flow chart of study selection according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard.
Figure 2.
Figure 2.
Risk of bias evaluation of randomized clinical trials according to Cochrane Collaboration risk of bias tool.
See this image and copyright information in PMC

References

    1. Adler S, Korner M, Forger F, Huscher D, Caversaccio MD, & Villiger PM (2013). Evaluation of histologic, serologic, and clinical changes in response to abatacept treatment of primary Sjogren’s syndrome: a pilot study. Arthritis Care Res (Hoboken), 65(11), 1862–1868. doi:10.1002/acr.22052 - DOI - PubMed
    1. Al Hamad A, Lodi G, Porter S, Fedele S, & Mercadante V (2018). Interventions for dry mouth and hyposalivation in Sjogren’s syndrome: A systematic review and meta-analysis. Oral Dis. doi:10.1111/odi.12952 - DOI - PubMed
    1. Alunno A, Leone MC, Giacomelli R, Gerli R, Carubbi F (2018). Lymphoma and Lymphomagenesis in Primary Sjögren’s Syndrome. Front Med 13(5),102. doi: 10.3389/fmed.2018.00102. - DOI - PMC - PubMed
    1. Bowman SJ, Everett CC, O’Dwyer JL, Emery P, Pitzalis C, Ng WF, … Bombardieri M (2017). Randomized Controlled Trial of Rituximab and Cost-Effectiveness Analysis in Treating Fatigue and Oral Dryness in Primary Sjogren’s Syndrome. Arthritis Rheumatol, 69(7), 1440–1450. doi:10.1002/art.40093 - DOI - PubMed
    1. Carsons SE, Vivino FB, Parke A, Carteron N, Sankar V, Brasington R, … Mandel S (2017). Treatment Guidelines for Rheumatologic Manifestations of Sjogren’s Syndrome: Use of Biologic Agents, Management of Fatigue, and Inflammatory Musculoskeletal Pain. Arthritis Care Res (Hoboken), 69(4), 517–527. doi:10.1002/acr.22968 - DOI - PubMed

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