title: Topical and systemic medications for the treatment of primary Sjögren's syndrome.
abstract: The treatment of primary Sjögren's syndrome (SS) is based principally on the management of sicca features and systemic manifestations. Sicca manifestations are treated symptomatically through administration of topical therapies, such as saliva substitutes and artificial tears; in patients with residual salivary gland function, stimulation of salivary flow with a sialogogue is the therapy of choice. The management of extraglandular features must be tailored to the specific organ or organs involved; however, limited data have been obtained from controlled trials in SS to guide the treatment of systemic symptoms using therapies including antimalarials, glucocorticoids, immunosuppressive drugs and biologic agents. Nevertheless, randomised controlled trials of biologic agents that target molecules and receptors involved in the aetiopathogenesis of primary SS have initiated a new era in the therapeutic management of the disease, although the potential risks and benefits of these agents must be carefully considered. In this Review, we analyse the evidence regarding the efficacy of the therapeutic agents currently available to treat the manifestations of SS. On the basis of this evidence, we provide guidance on the use of these agents in different clinical scenarios.
authors.affiliation: Sjögren's Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, Department of Autoimmune Diseases, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain. mramos@clinic.ub.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Ramos-Casals
authors.forename: Pilar
authors.initials: P
authors.lastname: Brito-Zerón
authors.forename: Antoni
authors.initials: A
authors.lastname: Sisó-Almirall
authors.forename: Xavier
authors.initials: X
authors.lastname: Bosch
authors.forename: Athanasios G
authors.initials: AG
authors.lastname: Tzioufas
mesh_terms: D000287:Administration, Topical; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012464:Saliva, Artificial / Q000008:administration & dosage / Q000627:therapeutic use*; D012472:Salivation / Q000187:drug effects; D012859:Sjogren's Syndrome / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D014987:Xerostomia / Q000188:drug therapy* / Q000209:etiology
chemical_list: D018501:Antirheumatic Agents; D009883:Ophthalmic Solutions; D012464:Saliva, Artificial