Speciality Medical Dialogues
    • facebook
    • twitter
    Login Register
    • facebook
    • twitter
    Login Register
    • Medical Dialogues
    • Education Dialogues
    • Business Dialogues
    • Medical Jobs
    • Medical Matrimony
    • MD Brand Connect
    Speciality Medical Dialogues
    • Editorial
    • News
        • Anesthesiology
        • Cancer
        • Cardiac Sciences
        • Critical Care
        • Dentistry
        • Dermatology
        • Diabetes and Endo
        • Diagnostics
        • ENT
        • Featured Research
        • Gastroenterology
        • Geriatrics
        • Medicine
        • Nephrology
        • Neurosciences
        • Nursing
        • Obs and Gynae
        • Ophthalmology
        • Orthopaedics
        • Paediatrics
        • Parmedics
        • Pharmacy
        • Psychiatry
        • Pulmonology
        • Radiology
        • Surgery
        • Urology
    • Practice Guidelines
        • Anesthesiology Guidelines
        • Cancer Guidelines
        • Cardiac Sciences Guidelines
        • Critical Care Guidelines
        • Dentistry Guidelines
        • Dermatology Guidelines
        • Diabetes and Endo Guidelines
        • Diagnostics Guidelines
        • ENT Guidelines
        • Featured Practice Guidelines
        • Gastroenterology Guidelines
        • Geriatrics Guidelines
        • Medicine Guidelines
        • Nephrology Guidelines
        • Neurosciences Guidelines
        • Obs and Gynae Guidelines
        • Ophthalmology Guidelines
        • Orthopaedics Guidelines
        • Paediatrics Guidelines
        • Psychiatry Guidelines
        • Pulmonology Guidelines
        • Radiology Guidelines
        • Surgery Guidelines
        • Urology Guidelines
    LoginRegister
    Speciality Medical Dialogues
    LoginRegister
    • Home
    • Editorial
    • News
      • Anesthesiology
      • Cancer
      • Cardiac Sciences
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endo
      • Diagnostics
      • ENT
      • Featured Research
      • Gastroenterology
      • Geriatrics
      • Medicine
      • Nephrology
      • Neurosciences
      • Nursing
      • Obs and Gynae
      • Ophthalmology
      • Orthopaedics
      • Paediatrics
      • Parmedics
      • Pharmacy
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
    • Practice Guidelines
      • Anesthesiology Guidelines
      • Cancer Guidelines
      • Cardiac Sciences Guidelines
      • Critical Care Guidelines
      • Dentistry Guidelines
      • Dermatology Guidelines
      • Diabetes and Endo Guidelines
      • Diagnostics Guidelines
      • ENT Guidelines
      • Featured Practice Guidelines
      • Gastroenterology Guidelines
      • Geriatrics Guidelines
      • Medicine Guidelines
      • Nephrology Guidelines
      • Neurosciences Guidelines
      • Obs and Gynae Guidelines
      • Ophthalmology Guidelines
      • Orthopaedics Guidelines
      • Paediatrics Guidelines
      • Psychiatry Guidelines
      • Pulmonology Guidelines
      • Radiology Guidelines
      • Surgery Guidelines
      • Urology Guidelines
    • Home
    • News
    • ENT
    • Sjogren's syndrome...

    Sjogren's syndrome management: EULAR Guidelines

    Written by Hina Zahid Published On 2019-11-29T19:00:34+05:30  |  Updated On 23 Aug 2021 4:21 PM IST

    New consensus-based recommendations from the European League Against Rheumatism (EULAR) address the management of Sjogren's syndrome with topical and systemic therapies.


    Sjogren's syndrome presents with a broad spectrum of clinical manifestations and autoantibodies, including antinuclear antibodies (the most frequently detected), anti-Ro/SS-A (the most specific), and cryoglobulins and hypocomplementemia (the main prognostic markers).


    For decades, the management of Sjogren's syndrome has been based on symptomatic treatment of sicca symptomatology and broad-spectrum immunosuppression for systemic disease, yet there is little information on the relative efficacy and safety of the available therapeutic options.


    Dr Manuel Ramos-Casals from Hospital Clinic of Barcelona, in Spain, and colleagues on the EULAR-Sjogren Syndrome Task Force reviewed the existing evidence and used a Delphi procedure to develop consensus recommendations for the management of Sjogren's syndrome.


    Three general principles underlie a dozen specific recommendations:




    • Patients with Sjogren's syndrome should be managed at, or in close collaboration with, centres of expertise following a multidisciplinary approach;

    • The first therapeutic approach for dryness should be symptomatic relief using topical therapies; and

    • Systemic therapies may be considered for the treatment of active systemic disease.


    After evaluation of salivary gland function, treatment for oral dryness should include nonpharmacological stimulation for mild dysfunction, pharmacological stimulation for moderate dysfunction, and saliva substitutes for severe dysfunction, the authors advise.


    Ocular dryness should be treated first with artificial tears and ocular gels/ointments, followed by topical immunosuppressive-containing drops and autologous serum eye drops for refractory or severe ocular dryness.


    Musculoskeletal pain can be managed with analgesics or other pain-modifying agents while balancing their potential benefits and side effects.


    Treatment of systemic disease should be tailored to organ-specific severity using the EULAR Sjogren's syndrome disease activity index (ESSDAI) definitions, according to the report, online October 31 in Annals of the Rheumatic Diseases.


    As a general rule, the systemic organ-specific therapeutic approach should consist of the sequential or combined use of glucocorticoids, immunosuppressive agents, and biologics.


    "The Task Force is convinced that adhering to these recommendations, including shared decision-making, assessing disease activity regularly with the ESSDAI instrument, and applying the sequence of drugs as proposed, will improve overall outcomes in a clear majority of patients with Sjogren's syndrome," the authors conclude.


    "New research information on treatment strategies, predictive markers, and other aspects will soon become available and will probably require an update of the recommendations in coming years," they add. "Until then, we hope that the current recommendations will be broadly applied in clinical practice and/or serve as a template for national societies to develop local recommendations."


    Dr Alan Baer from Johns Hopkins University School of Medicine, in Baltimore, MD, who studies Sjogren's, told Reuters Health by email, "Sjogren's is a disease with a high symptom burden for many patients and potentially serious complications for a minority. There should be an emphasis on accuracy of diagnosis, comprehensive evaluation, and evidence-based approaches to treatment."


    While he agrees that patients can benefit from management at expert centres, he notes that "such centres are rare in the United States, and specialists with the requisite expertise are few in number. Thus, it may prove impractical to have all Sjogren's patients managed in speciality centres."


    Dr Baer added, "The recommendations are hindered by the need to rely on data from limited clinical trials. The results of such trials may not capture impressive anecdotal data. As an example, many of my patients with severe dry eye gain dramatic relief from autologous serum tears. Similarly, I would expect many ophthalmologists would argue that punctal plug insertion is beneficial and should be tried earlier in the therapeutic algorithm (i.e., before the use of expensive autologous serum tears)."

    Annals of the Rheumatic DiseasesDr Alan BaerDr Manuel RamosEuropean League Against RheumatismSjogren's Syndrome
    Source : �Annals of the Rheumatic Diseases

    Disclaimer: This site is primarily intended for healthcare professionals. Any content/information on this website does not replace the advice of medical and/or health professionals and should not be construed as medical/diagnostic advice/endorsement or prescription. Use of this site is subject to our terms of use, privacy policy, advertisement policy. © 2020 Minerva Medical Treatment Pvt Ltd

    Hina Zahid
    Hina Zahid
      Show Full Article
      Next Story
      Similar Posts
      NO DATA FOUND

      • Email: info@medicaldialogues.in
      • Phone: 011 - 4372 0751

      Website Last Updated On : 12 Oct 2022 7:06 AM GMT
      Company
      • About Us
      • Contact Us
      • Our Team
      • Reach our Editor
      • Feedback
      • Submit Article
      Ads & Legal
      • Advertise
      • Advertise Policy
      • Terms and Conditions
      • Privacy Policy
      • Editorial Policy
      • Comments Policy
      • Disclamier
      Medical Dialogues is health news portal designed to update medical and healthcare professionals but does not limit/block other interested parties from accessing our general health content. The health content on Medical Dialogues and its subdomains is created and/or edited by our expert team, that includes doctors, healthcare researchers and scientific writers, who review all medical information to keep them in line with the latest evidence-based medical information and accepted health guidelines by established medical organisations of the world.

      Any content/information on this website does not replace the advice of medical and/or health professionals and should not be construed as medical/diagnostic advice/endorsement or prescription.Use of this site is subject to our terms of use, privacy policy, advertisement policy. You can check out disclaimers here. © 2025 Minerva Medical Treatment Pvt Ltd

      © 2025 - Medical Dialogues. All Rights Reserved.
      Powered By: Hocalwire
      X
      We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok