How effective are biological agents in treating Sjogren’s syndrome? How to choose?

Sjogren's syndrome is a systemic self- immune disease, characterized by inflammation in exocrine glands and lymph node invasion, particularly saliva and lacrimal gland damage, leading to the patient's mouth and dry eye

Sjogren's syndrome is a systemic self- immune disease, characterized by inflammation in exocrine glands and lymph node invasion, particularly saliva and lacrimal gland damage, leading to the patient's mouth and dry eye

B cell targeting inhibitors targeting cytostatic B 0 .
1 Rituximab Rituximab is an anti-CD20 monoclonal antibody, clinical studies on the treatment of SS rituximab more, but the results are not All the same
.
2016 Sjogren's Syndrome Foundation will (SSF) expert group on guidance rituximab as follows: Funds (1) Rituximab may be considered invalid as keratoconjunctivitis sicca and traditional treatment of primary drying comprehensive Levy the patient’s treatment options
.
(2) Rituximab may be considered for patients with primary Sjögren's syndrome and the system exhibits any of the following circumstances: vascular inflammation, with or without cryoglobulinemia, severe parotid gland swelling, inflammatory arthritis, pulmonary diseases Or peripheral neuropathy (especially polyneuritis)
.
Vascular (3) Rituximab can also be used for patients with xerostomia who have residual salivary glands, severe oral damage diagnosed by clinicians, and traditional treatments (local moisturizers, secretagogues) that have failed
.
The above content suggests that rituximab can help patients with Sjogren’s syndrome and system damage
.
0 2 Beili You mAb Beili biologies mAb directly against B cell activating factor (of BLyS), and few studies on Beili You currently mAb treatment of Sjogren's syndrome
.
In an open trial involving 30 patients with primary Sjogren’s syndrome, it was found that belimumab treatment for 28 weeks can reduce the disease activity index of Sjogren’s syndrome and improve the parotid gland enlargement, arthritis/arthralgia, and blood Immunoglobulin and rheumatoid factor levels
.
Improve patients' parotid gland enlargement, arthritis/arthralgia, blood immunoglobulin and rheumatoid factor levels
.
Improve patients' parotid gland enlargement, arthritis/arthralgia, blood immunoglobulin and rheumatoid factor levels
.
The salivaflow rate, Schirmer test scores and salivary gland biopsies localized does not change
.
However, in the subsequent 6-month follow-up, it was found that the symptoms of patients who responded to belyumumab treatment further improved, especially the symptoms of fatigue
.
In 2019, EULAR updated the treatment guidelines for Sjogren’s syndrome, which also suggested that belyumumab may be considered for the treatment of refractory Sjogren’s syndrome
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Among them, it is also suggested that belyumumab may be considered for the treatment of refractory Sjogren's syndrome
.
Among them, it is also suggested that belyumumab may be considered for the treatment of refractory Sjogren's syndrome
.
TNF-α Inhibitors TNF-α InhibitorsTNF-α inhibitors are not recommended for the treatment of Sjogren’s symptoms in patients with Sjogren’s syndrome (and rituximab is fine)
.
The risk of lymphoma in patients with Sjogren’s syndrome can be 8.
7-44 times higher than that of normal people, andthe risk of lymphoma inpatients with Sjogren’s syndromecan be 8.
7-44 times higher than that of normal people.
Although there is no evidence forSjogren’s syndrome,lymphomaThe use of TNF-α inhibitors in patients with symptoms of rheumatoid arthritis can increase the risk of lymphoma, but physicians should pay attention to vigilance and monitoring when using the treatment of Sjogren’s syndrome with rheumatoid or other related overlapping diseases
.
Therefore, TNF-α inhibitors may not improve Sjogren’s symptoms, but TNF-α inhibitors are not prohibited in Sjogren’s syndrome.
Patients with Sjogren’s syndrome combined with rheumatoid may still be considered for use, but it needs to be combined with the actual situation of the patient.
Carry out rational drug use and regular safety monitoring
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However, rational drug use and regular safety monitoring should be carried out based on the actual situation of patients
.
However, rational drug use and regular safety monitoring should be carried out based on the actual situation of patients
.
In addition, research on other new biological agents such as epalizumab, abatacept, CFZ533 (anti-CD40 monoclonal antibody) to treat Sjogren’s syndrome is also advancing, but its actual clinical efficacy still needs more evidence to support
.


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