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Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis

BACKGROUND: To systematically review and assess the efficacy and safety of hydroxychloroquine (HCQ) for treating primary Sjogren’s syndrome (pSS). METHODS: Five electronic databases (Pubmed, EMBASE, Web of science, Ovid, Cochrane Library) were searched for randomized controlled trials and retrospect...

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Autores principales: Wang, Shi-Qin, Zhang, Li-Wei, Wei, Pan, Hua, Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427554/
https://www.ncbi.nlm.nih.gov/pubmed/28499370
http://dx.doi.org/10.1186/s12891-017-1543-z
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author Wang, Shi-Qin
Zhang, Li-Wei
Wei, Pan
Hua, Hong
author_facet Wang, Shi-Qin
Zhang, Li-Wei
Wei, Pan
Hua, Hong
author_sort Wang, Shi-Qin
collection PubMed
description BACKGROUND: To systematically review and assess the efficacy and safety of hydroxychloroquine (HCQ) for treating primary Sjogren’s syndrome (pSS). METHODS: Five electronic databases (Pubmed, EMBASE, Web of science, Ovid, Cochrane Library) were searched for randomized controlled trials and retrospective or prospective studies published in English that reported the effect of HCQ on pSS. The subjective symptoms (sicca symptoms, fatigue and pain) and the objective indexes (erythrocyte sedimentation rate and Schirmer test) were assessed as main outcome measures. A meta-analysis and descriptive study on the efficacy and safety of HCQ were conducted. The estimate of the effect of HCQ treatment was expressed as a proportion together with 95% confidence interval, and plotted on a forest plot. RESULTS: Four trials with totals of 215 SS patients, including two randomized controlled trials, one double blind crossover trial and one retrospective open-label study, were analyzed in this review. For dry mouth and dry eyes, the effectiveness of HCQ treatment was essentially the same as placebo treatment. For fatigue, the effectiveness of HCQ was lower than placebo. The efficacy of HCQ in treating pain associated with pSS was superior to that of the placebo. There was no significant difference between HCQ-treated groups and controls in terms of Schirmer test results, but HCQ could reduce the erythrocyte sedimentation rate compare with placebo. A descriptive safety assessment showed that gastrointestinal adverse effects were the most common adverse effects associated with HCQ. CONCLUSIONS: This systematic review showed that there is no significant difference between HCQ and placebo in the treatment of dry mouth and dry eye in pSS. Well-designed, randomized, controlled trials are needed to provide higher-quality evidence to confirm our findings, and future studies should focus on some other index or extraglandular measures, such as cutaneous manifestations, to further explore the therapeutic effect of HCQ in pSS. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12891-017-1543-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-54275542017-05-15 Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis Wang, Shi-Qin Zhang, Li-Wei Wei, Pan Hua, Hong BMC Musculoskelet Disord Research Article BACKGROUND: To systematically review and assess the efficacy and safety of hydroxychloroquine (HCQ) for treating primary Sjogren’s syndrome (pSS). METHODS: Five electronic databases (Pubmed, EMBASE, Web of science, Ovid, Cochrane Library) were searched for randomized controlled trials and retrospective or prospective studies published in English that reported the effect of HCQ on pSS. The subjective symptoms (sicca symptoms, fatigue and pain) and the objective indexes (erythrocyte sedimentation rate and Schirmer test) were assessed as main outcome measures. A meta-analysis and descriptive study on the efficacy and safety of HCQ were conducted. The estimate of the effect of HCQ treatment was expressed as a proportion together with 95% confidence interval, and plotted on a forest plot. RESULTS: Four trials with totals of 215 SS patients, including two randomized controlled trials, one double blind crossover trial and one retrospective open-label study, were analyzed in this review. For dry mouth and dry eyes, the effectiveness of HCQ treatment was essentially the same as placebo treatment. For fatigue, the effectiveness of HCQ was lower than placebo. The efficacy of HCQ in treating pain associated with pSS was superior to that of the placebo. There was no significant difference between HCQ-treated groups and controls in terms of Schirmer test results, but HCQ could reduce the erythrocyte sedimentation rate compare with placebo. A descriptive safety assessment showed that gastrointestinal adverse effects were the most common adverse effects associated with HCQ. CONCLUSIONS: This systematic review showed that there is no significant difference between HCQ and placebo in the treatment of dry mouth and dry eye in pSS. Well-designed, randomized, controlled trials are needed to provide higher-quality evidence to confirm our findings, and future studies should focus on some other index or extraglandular measures, such as cutaneous manifestations, to further explore the therapeutic effect of HCQ in pSS. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12891-017-1543-z) contains supplementary material, which is available to authorized users. BioMed Central 2017-05-12 /pmc/articles/PMC5427554/ /pubmed/28499370 http://dx.doi.org/10.1186/s12891-017-1543-z Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Wang, Shi-Qin
Zhang, Li-Wei
Wei, Pan
Hua, Hong
Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis
title Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis
title_full Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis
title_fullStr Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis
title_full_unstemmed Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis
title_short Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis
title_sort is hydroxychloroquine effective in treating primary sjogren’s syndrome: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427554/
https://www.ncbi.nlm.nih.gov/pubmed/28499370
http://dx.doi.org/10.1186/s12891-017-1543-z
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