title: Treatment of Sjögren's syndrome-associated dry eye an evidence-based review.
abstract: BACKGROUND
  Outcomes-based review of reported treatment options for patients with dry eye secondary to Sjögren's syndrome (SS).
  
  
  CONCLUSIONS
  Dry eye affects many individuals worldwide. Significant proportion of patients with dry eye has underlying SS, a progressive autoimmune condition. The few suggested guidelines for the treatment of dry eye are mostly based on severity of symptoms and/or clinical findings rather than on outcomes analysis, and do not differentiate SS from other causes of dry eye. METHODS AND LITERATURE REVIEW: A search strategy was developed to identify prospective, interventional studies of treatments for SS-associated dry eye from electronic databases. Eligible references were restricted to English-language articles published after 1975. These sources were augmented by hand searches of reference lists from accessed articles. Study selection, data extraction, and grading of evidence were completed independently by ≥4 review authors.
  
  
  RESULTS
  The searches identified 3559 references as of August 10, 2010. After duplicate review of the titles and abstracts, 245 full-text papers were assessed, 62 of which were relevant for inclusion in the review.
  
  
  CONCLUSIONS
  In the current literature on SS-associated dry eye, there is a paucity of rigorous clinical trials to support therapy recommendations. Nonetheless, the recommended treatments include topical lubricants, topical anti-inflammatory therapy, and tear-conserving strategies. The efficacy of oral secretagogues seems greater in the treatment of oral dryness than ocular dryness. Although oral hydroxychloroquine is commonly prescribed to patients with SS to alleviate fatigue and arthralgias, the literature lacks strong evidence for the efficacy of this treatment for dry eye.
authors: The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. esakpek@jhmi.edu
authors: Esen Karamursel
authors: EK
authors: Akpek
authors: Kristina B
authors: KB
authors: Lindsley
authors: Rohit S
authors: RS
authors: Adyanthaya
authors: Ramya
authors: R
authors: Swamy
authors: Alan N
authors: AN
authors: Baer
authors: Peter J
authors: PJ
authors: McDonnell
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000209:etiology*; D019317:Evidence-Based Medicine; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D054327:Lubricants / Q000008:administration & dosage; D010862:Pilocarpine / Q000627:therapeutic use; D011812:Quinuclidines / Q000627:therapeutic use; D012859:Sjogren's Syndrome / Q000150:complications* / Q000188:drug therapy; D013876:Thiophenes / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D054327:Lubricants; D011812:Quinuclidines; D013876:Thiophenes; D010862:Pilocarpine; D006886:Hydroxychloroquine; C059240:cevimeline