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Effectiveness of pharmacological interventions for Sjogren syndrome - A systematic review

BACKGROUND: Sjogren’s Syndrome (SS) is characterized by xeropthalmia and/or xerostomia. Treating the associated salivary gland hypofunction has been challenging to the clinicians. A variety of topical and systemic therapies have been tried to restore/stimulate the gland function or replace saliva re...

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Autores principales: Choudhary, Ruchika, Reddy, Sujatha S., Nagaraju, Rakesh, Nagi, Ravleen, Rathore, Pooja, Sen, Ritu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medicina Oral S.L. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9899366/
https://www.ncbi.nlm.nih.gov/pubmed/36755678
http://dx.doi.org/10.4317/jced.59891
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author Choudhary, Ruchika
Reddy, Sujatha S.
Nagaraju, Rakesh
Nagi, Ravleen
Rathore, Pooja
Sen, Ritu
author_facet Choudhary, Ruchika
Reddy, Sujatha S.
Nagaraju, Rakesh
Nagi, Ravleen
Rathore, Pooja
Sen, Ritu
author_sort Choudhary, Ruchika
collection PubMed
description BACKGROUND: Sjogren’s Syndrome (SS) is characterized by xeropthalmia and/or xerostomia. Treating the associated salivary gland hypofunction has been challenging to the clinicians. A variety of topical and systemic therapies have been tried to restore/stimulate the gland function or replace saliva reducing the symptoms of xerostomia and to avoid the problems of diminished salivary flow. MATERIAL AND METHODS: Four search engines (PUBMED/Medline, EMBASE, Google Scholar and The Cochrane) were used in conducting a systematic review using the terms “Sjogren’s syndrome” with the combination of other terms. To define these study acceptability criteria, we used PICO model (Population, Intervention, Control and Outcome) and study design technique. RESULTS: Out of 47 articles initially screened, 28 studies met our selection criteria. Included studies showed positive results with interventions such as pilocarpine, rituximab, and interferon-alpha (IFN-α) for enhancing salivary flow and lacrimal secretion in SS condition. One study showed promising results for combination of prednisone and hydroxychloroquine in SS, however dose of prednisone is recommended to be tapered. Another study demonstrated comparable effects of dehydroepiandrosterone and the placebo in alleviation of dry mouth symptoms (p=0.006). Therapeutic effects have been reported with LASER therapy. CONCLUSIONS: Pilocarpine was found to be highly beneficial whereas, rituximab and IFN-α were moderately effective in the reduction of hyposalivation in SS patient. Adverse events were common. Use of any alternative modalities for the management cannot be supported based on the current evidence; this demands more studies in future to be conducted staking into account adverse effects which might occur particularly with the pharmacological therapies. Key words:Sjogren’s Syndrome, Xerostomia, Hyposalivation, Pilocarpine, Rituximab, Sialagogue.
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spelling pubmed-98993662023-02-07 Effectiveness of pharmacological interventions for Sjogren syndrome - A systematic review Choudhary, Ruchika Reddy, Sujatha S. Nagaraju, Rakesh Nagi, Ravleen Rathore, Pooja Sen, Ritu J Clin Exp Dent Review BACKGROUND: Sjogren’s Syndrome (SS) is characterized by xeropthalmia and/or xerostomia. Treating the associated salivary gland hypofunction has been challenging to the clinicians. A variety of topical and systemic therapies have been tried to restore/stimulate the gland function or replace saliva reducing the symptoms of xerostomia and to avoid the problems of diminished salivary flow. MATERIAL AND METHODS: Four search engines (PUBMED/Medline, EMBASE, Google Scholar and The Cochrane) were used in conducting a systematic review using the terms “Sjogren’s syndrome” with the combination of other terms. To define these study acceptability criteria, we used PICO model (Population, Intervention, Control and Outcome) and study design technique. RESULTS: Out of 47 articles initially screened, 28 studies met our selection criteria. Included studies showed positive results with interventions such as pilocarpine, rituximab, and interferon-alpha (IFN-α) for enhancing salivary flow and lacrimal secretion in SS condition. One study showed promising results for combination of prednisone and hydroxychloroquine in SS, however dose of prednisone is recommended to be tapered. Another study demonstrated comparable effects of dehydroepiandrosterone and the placebo in alleviation of dry mouth symptoms (p=0.006). Therapeutic effects have been reported with LASER therapy. CONCLUSIONS: Pilocarpine was found to be highly beneficial whereas, rituximab and IFN-α were moderately effective in the reduction of hyposalivation in SS patient. Adverse events were common. Use of any alternative modalities for the management cannot be supported based on the current evidence; this demands more studies in future to be conducted staking into account adverse effects which might occur particularly with the pharmacological therapies. Key words:Sjogren’s Syndrome, Xerostomia, Hyposalivation, Pilocarpine, Rituximab, Sialagogue. Medicina Oral S.L. 2023-01-01 /pmc/articles/PMC9899366/ /pubmed/36755678 http://dx.doi.org/10.4317/jced.59891 Text en Copyright: © 2023 Medicina Oral S.L. https://creativecommons.org/licenses/by/2.5/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Choudhary, Ruchika
Reddy, Sujatha S.
Nagaraju, Rakesh
Nagi, Ravleen
Rathore, Pooja
Sen, Ritu
Effectiveness of pharmacological interventions for Sjogren syndrome - A systematic review
title Effectiveness of pharmacological interventions for Sjogren syndrome - A systematic review
title_full Effectiveness of pharmacological interventions for Sjogren syndrome - A systematic review
title_fullStr Effectiveness of pharmacological interventions for Sjogren syndrome - A systematic review
title_full_unstemmed Effectiveness of pharmacological interventions for Sjogren syndrome - A systematic review
title_short Effectiveness of pharmacological interventions for Sjogren syndrome - A systematic review
title_sort effectiveness of pharmacological interventions for sjogren syndrome - a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9899366/
https://www.ncbi.nlm.nih.gov/pubmed/36755678
http://dx.doi.org/10.4317/jced.59891
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