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World Workshop on Oral Medicine VII : Immunobiologics for salivary gland disease in Sjögren's syndrome: A systematic review
Author(s) -
Gueiros Luiz A.,
France Katherine,
Posey Rachael,
Mays Jacqueline W.,
Carey Barbara,
Sollecito Thomas P.,
Setterfield Jane,
Woo Sook Bin,
Culton Donna,
Payne Aimee S.,
Lodi Giovanni,
Greenberg Martin S.,
De Rossi Scott
Publication year - 2019
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/odi.13062
Subject(s) - medicine , rituximab , belimumab , abatacept , salivary gland , cochrane library , disease , randomized controlled trial , quality of life (healthcare) , medline , observational study , dermatology , immunology , antibody , b cell activating factor , b cell , lymphoma , political science , law , nursing
Objective This systematic review evaluated the efficacy of immunobiologics for the management of oral disease in Sjögren's syndrome (SS). Materials and Methods MEDLINE ® , Embase, Scopus, and the Cochrane Library were searched for evidence on the use of immunobiologics for management of glandular disease in SS. Primary outcomes were xerostomia and salivary gland dysfunction, assessed via visual analogue scales, disease‐specific scales for SS, measurement of salivary flow, ultrasound data, and quality of life measures. Results Seventeen studies (11 randomized controlled trials and 6 observational studies) met inclusion criteria. Rituximab showed efficacy in improving salivary gland function but not xerostomia. Abatacept showed promise in improving both xerostomia and salivary flow. Belimumab exhibited long‐term improvement of salivary flow and subjective measures. The novel agent CFZ 533 improved both disease activity and patient‐reported indexes. Conclusions There is strong evidence pointing to the efficacy of rituximab in the management of oral disease in SS. Future controlled trials may elucidate the efficacy of belimumab and abatacept. The new drug CFZ 533 is a promising alternative for the management of SS and its salivary gland involvement. In considering these agents, the promise of efficacy must be balanced against the harmful effects associated with biologic agents.