[Indications and options of new immune modulatory therapies for Sjögren's syndrome].
Sjögren's syndrome is a systemic inflammatory rheumatic disorder of unknown origin with so far inadequate therapy options. Management of Sjögren's syndrome is still primarily palliative using local symptomatic measures, and if appropriate glucocorticoids, NSAIDs and immunosuppressive drugs. New clues to the pathogenesis of this disorder pave the way for new therapeutic strategies. In particular targeting B-cells offers promising results and emphasizes the role of B-cells in the pathogenesis of this complex disorder. Rituximab was introduced into the standard treatment of different forms of low-grade and high-grade B-cell non-Hodgkins lymphomas, and is also an option for some lymphomas associated with Sjögren's syndrome. Whether interference with T-cell function is also a safe and effective strategy in Sjögren's syndrome, has to be shown in controlled clinical trials. However, there is no clear evidence to suggest that treatment with TNF-alpha blockers is efficacious in Sjögren's syndrome. Standardization of disease activity and outcome measurements are critical for further clinical trials for Sjögren's syndrome.
Feist
E
E
Interdisziplinäres Sjögren-Syndrom-Centrum, Berlin, Germany. eugen.feist@charite.de
Dörner
T
T
Hansen
A
A
D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D016207:Cytokines / Q000037:antagonists & inhibitors / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000276:immunology; D016032:Randomized Controlled Trials as Topic; D012859:Sjogren's Syndrome / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D016207:Cytokines; D007166:Immunosuppressive Agents