[Treatment of oral dryness in Sjögren's syndrome].
OBJECTIVE
In Sjögren's syndrome (SS), oral dryness is frequently the most bothersome symptom of sicca syndrome with negative affects on quality of life. A review of treatments of oral dryness is proposed.


BACKGROUND
To date, so specific DMARD has demonstrated its efficacy in SS. Hydroxychloroquine is frequently used but did not demonstrate any clinical benefit in te only small randomized control study versus placebo available. Thus, the only treatments are symptomatic. The most recent data show that systemic cholinergic agonist (pilocarpine and cevimeline) are effective in the symptomatic treatment of dryness. Pilocarpine (Salagen) is the only systemic cholinergic agonist available in Europe. It has been agreed in France since July 2003.


CONCLUSIONS
Use of immunosuppressive drugs may be useful in some complications of SS. Unfortunately, promising results from an open study with infliximab (Remicade) were not confirmed by a large randomized control study involving more than 100 patients. New control studies with old drugs such as hydroxychloroquine, or new ones such as rituximab, are mandatory.
Mariette
X
X
Service de rhumatologie, hôpital de Bicêtre, Assistance publique-Hôpitaux de Paris, université Paris-Sud, Le Kremlin-Bicêtre, France. xavier.mariette@bct.ap-hop-paris.fr
D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D018721:Muscarinic Agonists / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012859:Sjogren's Syndrome / Q000150:complications*; D016896:Treatment Outcome; D014987:Xerostomia / Q000188:drug therapy* / Q000209:etiology*
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D018721:Muscarinic Agonists; D000069285:Infliximab