What is the effect of biological agents in the treatment of 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
.

In addition, the disease can also affect multiple organ systems such as the lungs, kidneys, liver, and joints

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

(Source: Photograph Network)

(Source: Photograph Network)

 

At present, there is no radical cure for Sjogren’s syndrome.
The main treatment principles are symptomatic treatment to improve the patient’s dry symptoms, enhance the residual function of the exocrine glands, improve the immune pathological process through systemic medication, and protect organ functions
.

Improve its immune pathological process through systemic medication and protect organ function

Targeted B cell inhibitor

 

0 1 rituximab rituximab Rituximab is an anti-CD20 monoclonal antibody, clinical studies on the SS rituximab therapy more, but the results are not 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

0 2 Beliyuumab Beliyuumab

 

 Bellyumumab is a biological agent that directly targets B cell activating factor (BLyS).
There are currently few studies on belyumumab in the 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 The level of immunoglobulin and rheumatoid factor

(Source: Photograph Network)

(Source: Photograph Network)

 

TNF-α inhibitor

 

TNF-α inhibitors are not recommended for the treatment of Sjogren's symptoms in patients with Sjogren's syndrome (and rituximab can)
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The risk of lymphoma in patients with Sjogren’s syndrome can be 8.
7-44 times higher than that of normal people, and the risk of lymphoma in patients with Sjogren’s syndrome can be 8.
7-44 times higher than that of normal people.
Although there is no evidence for Sjogren’s syndrome , lymphoma The 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
.
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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