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Clinical Guidelines for Sjögren’s Syndrome Focus on Biologics, Fatigue, Inflammatory Musculoskeletal Pain

  |  Issue: June 2017  |  

Key recommendations include a decision tree for the use of oral disease-modifying anti-rheumatic drugs for inflammatory musculoskeletal pain, use of self-care measures and advice regarding exercise to reduce fatigue, and the use of rituximab in selected clinical settings for oral and ocular dryness and for certain extraglandular manifestations, including vasculitis, severe parotid swelling, inflammatory arthritis, pulmonary disease and mononeuritis multiplex.

The use of tumor necrosis factor inhibitors for sicca symptoms and for the majority of clinical contexts in primary Sjögren’s syndrome is strongly discouraged.

References

  1. Carsons SE, Vivino FB, Parke A, et al. Treatment guidelines for rheumatologic manifestations of Sjögren’s syndrome: Use of biologic agents, management of fatigue, and inflammatory musculoskeletal pain. Arthritis Care Res (Hoboken). 2017 Apr;69(4):517–527.
  2. Shiboski CH, Shiboski SC, Seror R, et al. 2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjögren’s syndrome: A consensus and data-driven methodology involving three international patient cohorts. Arthritis Rheumatol. 2017 Jan;69(1):35–45.
  3. Zero DT, Brennan MT, Daniels TE, et al. Clinical practice guidelines for oral management of Sjögren disease: Dental caries prevention. J Am Dent Assoc. 2016 Apr;147(4):295–305.
  4. Foulks GN, Forstot SL, Donshik PC, et al. Clinical guidelines for management of dry eye associated with Sjögren’s disease. Ocul Surf. 2015 Apr;13(2):118–132.
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