title: Safety of treatments for primary Sjögren's syndrome.
abstract: BACKGROUND
  Primary Sjögren's syndrome (pSS) is a disabling auto-immune disease, affecting exocrine glands and several organs.
  
  
  METHODS
  In this review we analyze the safety of therapies used in pSS. Symptomatic treatment is widely applied due to the good supportive effect and good safety profile. Systemic stimulation of tears and saliva can be successful in pSS. However, cumbersome adverse events can influence the tolerability of this therapy. Evidence for the effectiveness of synthetic DMARDs therapies in pSS is limited, while there is a risk of adverse events. Several studies on biologic DMARD treatment of pSS patients have shown promising efficacy and safety results.
  
  
  CONCLUSIONS
  The safety of symptomatic treatment of pSS is very good. However, systemic therapy is necessary to achieve long-term relieve and prevention of organ-damage. Synthetic DMARDs have not shown much efficacy in earlier studies, and their benefits do not weigh up to the possible harms, while biologic DMARDs show promising results regarding efficacy and cause mostly mild adverse events. Many questions remain unanswered regarding safety of DMARDs in pSS. There is a need for well designed studies, in which safety should be evaluated in a uniform manner to be able to compare the results between studies.
authors.affiliation: a Department of Rheumatology and Clinical Immunology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.
authors.forename: Jolien F
authors.initials: JF
authors.lastname: van Nimwegen
authors.affiliation: a Department of Rheumatology and Clinical Immunology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.
authors.forename: Rada V
authors.initials: RV
authors.lastname: Moerman
authors.affiliation: b Department of Ophthalmology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.
authors.forename: Nicole
authors.initials: N
authors.lastname: Sillevis Smitt
authors.affiliation: a Department of Rheumatology and Clinical Immunology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Brouwer
authors.affiliation: a Department of Rheumatology and Clinical Immunology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.
authors.forename: Hendrika
authors.initials: H
authors.lastname: Bootsma
authors.affiliation: c Department of Oral and Maxillofacial Surgery , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.
authors.forename: Arjan
authors.initials: A
authors.lastname: Vissink
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D012449:Safety; D012859:Sjogren's Syndrome / Q000188:drug therapy*
chemical_list: D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents
keywords: Primary Sjögren’s syndrome; biologic DMARDs; drug safety; synthetic DMARDs; topical treatment