scholarly journals Significance and Implications of Patient-reported Xerostomia in Sjögren's Syndrome: Findings From the National Institutes of Health Cohort

EBioMedicine ◽  
2016 ◽  
Vol 12 ◽  
pp. 270-279 ◽  
Author(s):  
Monisha Billings ◽  
Bruce A. Dye ◽  
Timothy Iafolla ◽  
Alan N. Baer ◽  
Margaret Grisius ◽  
...  
Keyword(s):  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
National Institutes Of Health ◽  
Patient Reported ◽  
Sjögren‘S Syndrome

Sjögren’s syndrome—management

2014 ◽  
Author(s):  
Wan-Fai Ng ◽  
Arjan Vissink ◽  
Elke Theander ◽  
Francisco Figueiredo
Keyword(s):  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Salivary Flow ◽  
Patient Reported Outcome Measures ◽  
Sjogren's Syndrome ◽  
Classification Criteria ◽  
Disease Assessment ◽  
Patient Reported ◽  
Sjögren‘S Syndrome

Management of Sjögren’s syndrome (SS) encompasses confirmation of diagnosis, disease assessment, and treatment of glandular and systemic manifestations including special situations such as pregnancy and SS-related lymphoma. The American European Consensus Group (AECG) classification criteria 2002 are the current gold standard for the diagnosis of SS. Salivary gland sialometry, sialochemistry, and ultrasound and tear osmolarity may be useful adjuncts. Recently, preliminary classification criteria of the American College of Rheumatology have been introduced as an alternative to the AECG criteria. Symptoms of SS are non-specific and must be actively explored. When assessing patients with SS, it is important to consider not only objective parameters such as abnormalities in blood tests and changes in tear and salivary flow, but also patient-reported outcome measures and impact on quality of life. Current management of patients with SS is hampered by the lack of evidence-based strategies. The symptoms experienced by patients with SS are often not fully appreciated by clinicians, which may contribute to the suboptimal management of the condition. Management of fatigue remains a major challenge and a holistic, multidisciplinary approach is recommended. Factors that may contribute to fatigue should be fully addressed. Recent advances in the understanding of the pathogenic mechanisms of SS have informed more targeted therapeutic strategies with some promising data. Optimal management of SS requires expertise from different disciplines. Combined clinics with rheumatology, oral medicine, and ophthalmology input will improve care and communications as well as reduce the number of clinic visits for patients and healthcare-related cost. Effective link between pSS specialists, dentists, opticians, and general practitioners will facilitate early diagnosis and reduce risk of long-term disability of SS.

scholarly journals Efficacy and safety of abatacept in active primary Sjögren’s syndrome: results of a phase III, randomised, placebo-controlled trial

2020 ◽  
pp. annrheumdis-2020-218599
Author(s):  
Alan N Baer ◽  
Jacques-Eric Gottenberg ◽  
E William St Clair ◽  
Takayuki Sumida ◽  
Tsutomu Takeuchi ◽  
...  
Keyword(s):  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Controlled Trial ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Phase Iii ◽  
Open Label ◽  
Double Blind ◽  
Patient Reported ◽  
Sjögren‘S Syndrome

ObjectivesTo evaluate efficacy and safety of abatacept in adults with active primary Sjögren’s syndrome (pSS) in a phase III, randomised, double-blind, placebo-controlled trial.MethodsEligible patients (moderate-to-severe pSS [2016 ACR/European League Against Rheumatism (EULAR) criteria], EULAR Sjögren’s Syndrome Disease Activity Index [ESSDAI] ≥5, anti-SS-related antigen A/anti-Ro antibody positive) received weekly subcutaneous abatacept 125 mg or placebo for 169 days followed by an open-label extension to day 365. Primary endpoint was mean change from baseline in ESSDAI at day 169. Key secondary endpoints were mean change from baseline in EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI) and stimulated whole salivary flow (SWSF) at day 169. Other secondary clinical endpoints included glandular functions and patient-reported outcomes. Selected biomarkers and immune cell phenotypes were examined. Safety was monitored.ResultsOf 187 patients randomised, 168 completed double-blind period and 165 continued into open-label period. Mean (SD) baseline ESSDAI and ESSPRI total scores were 9.4 (4.3) and 6.5 (2.0), respectively. Statistical significance was not reached for primary (ESSDAI −3.2 abatacept vs −3.7 placebo, p=0.442) or key secondary endpoints (ESSPRI, p=0.337; SWSF, p=0.584). No clinical benefit of abatacept over placebo at day 169 was seen with other clinical and PRO endpoints. Relative to baseline, abatacept was associated with significant differences vs placebo in some disease-relevant biomarkers (including IgG, IgA, IgM-rheumatoid factor) and pathogenic cell subpopulations (post hoc analyses). No new safety signals were identified.ConclusionsAbatacept treatment did not result in significant clinical efficacy compared with placebo in patients with moderate-to-severe pSS, despite evidence of biological activity.

scholarly journals Validação e propriedades psicométricas do Eular Sjögren's Syndrome Patient Reported Index (ESSPRI) para a língua portuguesa

2015 ◽  
Vol 55 (5) ◽  
pp. 439-445 ◽  
Author(s):  
Maurício Aquino Paganotti ◽  
Valéria Valim ◽  
Érica Vieira Serrano ◽  
Samira Tatiyama Miyamoto ◽  
Raquel Altoé Giovelli ◽  
...  
Keyword(s):  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Syndrome Patient ◽  
Patient Reported ◽  
Sjögren‘S Syndrome

Sjögren’s syndrome—management

2013 ◽  
Author(s):  
Wan-Fai Ng ◽  
Arjan Vissink ◽  
Elke Theander ◽  
Francisco Figueiredo
Keyword(s):  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Salivary Flow ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Sjogren's Syndrome ◽  
Disease Assessment ◽  
Patient Reported ◽  
Sjögren‘S Syndrome

Management of Sjögren's syndrome (SS) encompasses confirmation of diagnosis, disease assessment, and treatment of glandular and systemic manifestations including special situations such as pregnancy and SS-related lymphoma. The American European Consensus Group classification criteria 2002 are the current gold standard for the diagnosis of SS. Salivary gland sialometry, sialochemistry, and ultrasound and tear osmolarity may be useful adjuncts. Symptoms of SS are non-specific and must be actively explored. When assessing patients with SS, it is important to consider not only objective parameters such as abnormalities in blood tests and changes in tear and salivary flow, but also patient-reported outcome measures and impact on quality of life. Current management of patients with SS is hampered by the lack of evidence-based strategies. The symptoms experienced by patients with SS are often not fully appreciated by clinicians, which may contribute to the suboptimal management of the condition. Management of fatigue remains a major challenge and a holistic, multidisciplinary approach is recommended. Factors that may contribute to fatigue should be fully addressed. Recent advances in the understanding of the pathogenic mechanisms of SS have informed more targeted therapeutic strategies with some promising data. Optimal management of SS requires expertise from different disciplines. Combined clinics with rheumatology, oral medicine, and ophthalmology input will improve care and communications as well as reduce the number of clinic visits for patients and healthcare-related cost. Effective link between pSS specialists, dentists, opticians, and general practitioners will facilitate early diagnosis and reduce risk of long-term disability of SS.

Renal tubular acidosis as a clinical presentation of Sjögren's syndrome: case report

2019 ◽  
pp. 26-28
Author(s):  
D. Fernández Ávila ◽  
A. Vargas Caselles ◽  
O. Diz
Keyword(s):  
Sjögren’S Syndrome ◽  
Renal Tubular Acidosis ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Type I ◽  
Ammonium Excretion ◽  
Patient Reported ◽  
Renal Tubular ◽  
Sjögren‘S Syndrome

We present the clinical case of a woman in the fifth decade of life, argentina, who went to the Internal Medicine emergency room of a third level hospital for symptoms of myalgia and paresis in all four extremities, acute onset, progressive, with difficulty for the mobilization of members superior, standing and walking. Severe hypokalemia, metabolic acidosis, alkaline urinary pH, positive urinary anion GAP (ammonium excretion), hypocitraturia and hypercalciuria were diagnosed. Renal Tubular Acidosis (RTA) type I was diagnosed; acute renal failure was also noted, which corrected with the treatment and elevated creatine kinase (CK). In the anamnesis, the patient reported dry syndrome associated with arthralgias of years of evolution, so that complementary studies were carried out that supported the diagnosis of Sjögren’s Syndrome (SS).

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