[Treatment of primary Sjögren syndrome]
| Autor: | Valérie Devauchelle-Pensec, Jacques-Olivier Pers, Alain Saraux |
|---|---|
| Přispěvatelé: | Service de Rhumatologie [CHU de la Cavale-Blanche], Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, Michel, Geneviève, CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest) |
| Jazyk: | francouzština |
| Rok vydání: | 2012 |
| Předmět: |
0301 basic medicine
MESH: Fatigue Lung Diseases Pathology medicine.medical_treatment Sialic Acid Binding Ig-like Lectin 2 Severity of Illness Index law.invention 0302 clinical medicine Randomized controlled trial law Interferon Epidemiology B-Cell Activating Factor Molecular Targeted Therapy Fatigue MESH: Polyneuropathies Arthralgia 3. Good health Biological Therapy Artificial tears Sjogren's Syndrome Cryoglobulinemia MESH: Sialic Acid Binding Ig-like Lectin 2 [SDV.IMM]Life Sciences [q-bio]/Immunology Dry Eye Syndromes MESH: Pain Nephritis MESH: Pain Management medicine.drug medicine.medical_specialty [SDV.IMM] Life Sciences [q-bio]/Immunology education Pain Salivary Gland Diseases Skin Diseases Xerostomia Proinflammatory cytokine 03 medical and health sciences Polyneuropathies Rheumatology MESH: Salivary Gland Diseases Muscular Diseases Internal medicine Severity of illness medicine Humans Pain Management MESH: B-Cell Activating Factor 030203 arthritis & rheumatology Autoimmune disease MESH: Humans business.industry Tumor Necrosis Factor-alpha Arthritis medicine.disease 030104 developmental biology MESH: Sjogren's Syndrome MESH: Tumor Necrosis Factor-alpha Nephritis Interstitial Nervous System Diseases business |
| Zdroj: | Nature Reviews Rheumatology Nature Reviews Rheumatology, Nature Publishing Group, 2016, 12 (8), pp.456-71 Revue du Praticien (La) Revue du Praticien (La), J B Bailliere et Fils, 2012, 62 (2), pp.234-8 |
| ISSN: | 0035-2640 1759-4804 |
| Popis: | International audience; Primary Sjögren syndrome (pSS) is a progressive autoimmune disease characterized by sicca and systemic manifestations. In this Review, we summarize the available data on topical and systemic medications, according to clinical signs and disease activity, and we describe the ongoing studies using biologic drugs in the treatment of pSS. Expanding knowledge about the epidemiology, classification criteria, systemic activity scoring (ESSDAI) and patient-reported outcomes (ESSPRI) is driving active research. Treatment decisions are based on the evaluation of symptoms and extraglandular manifestations. Symptomatic treatment is usually appropriate, whereas systemic treatment is reserved for systemic manifestations. Sicca is managed by education, environment modification, elimination of contingent offending drugs, artificial tears, secretagogues and treatments for complications. Mild systemic signs such as fatigue are treated by exercise. Pain can require short-term moderate-dose glucocorticoid therapy and, in some cases, disease-modifying drugs. Severe and acute systemic manifestations indicate treatment with glucocorticoids and/or immunosuppressant drugs. The role for biologic agents is promising, but no double-blind randomized controlled trials (RCTs) proving the efficacy of these drugs are available. Targets for new treatments directed against the immunopathological mechanisms of pSS include epithelial cells, T cells, B-cell overactivity, the interferon signature, proinflammatory cytokines, ectopic germinal centre formation, chemokines involved in lymphoid cell homing, and epigenetic modifications. |
| Databáze: | OpenAIRE |
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