Editorial: Rituximab in the Treatment of Sjögren's Syndrome: Is It the Right or Wrong Drug?

Bootsma, Hendrika; Kroese, Frans G. M.; Vissink, Arjan

doi:10.1002/art.40095

Cited by 16 publications

(3 citation statements)

References 25 publications

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“…Moreover, conducted clinical studies using biological drugs, i.e. B cells depleting rituximab and BAFF neutralising belimumab, were not unanimous in reaching the primary efficacy endpoints [2, 3, 29].…”

Section: Discussionmentioning

confidence: 99%

Subgroups of Sjögren’s syndrome patients categorised by serological profiles: clinical and immunological characteristics

Kontny¹,

Lewandowska-Poluch²,

Chmielińska³

et al. 2018

Reumatologia

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ObjectivesSjögren’s syndrome (SS) is an autoimmune disease characterised by heterogeneous clinical presentation and presence of various autoantibodies – anti-SSA/Ro of diagnostic value, less specific anti-SSB/La and others. We searched for biomarker(s) and potential therapeutic target(s) of SS subsets that vary in their autoantibody profile.Material and methodsEighty-one patients with SS (70 female and 11 male) and 38 healthy volunteers (28 female and 10 male) were included in the study. Patients were categorised according to absence (group 1) or presence of anti-SSA/Ro antibody which occurred either alone (group 2) or together with anti-SSB/La (group 3). Clinical evaluation was performed, and presence of autoantibodies and concentrations of cytokines relevant to SS pathogenesis, i.e. a proliferation inducing ligand (APRIL), B-lymphocyte activating factor (BAFF), interleukin (IL) 4, IL-10, interferon α (IFN-α) and thymic stromal lymphopoietin (TSLP), in sera were determined.ResultsFrequency of autoantibodies other than anti-SSA/Ro and anti-SSB/La, the number of autoantibody specificities and anti-nuclear antibody titres were higher in group 2 and/or 3 than in group 1 of SS patients. Moreover, SS patients of groups 2 and 3 developed disease symptoms at younger age, and more often had positive Schirmer’s test and skin lesions. In addition, serum concentrations of APRIL, but not other tested cytokines, were significantly higher in the patients of both groups 2 and 3 than those of group 1 and healthy volunteers.ConclusionsSjögren’s syndrome patients with signs of B-cell epitope spreading are characterised by early disease onset, more frequent xerophthalmia and skin involvement, and up-regulated serum APRIL level. We suggest that therapeutic neutralisation of APRIL may be beneficial for these patients.

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Section: Discussionmentioning

confidence: 99%

Subgroups of Sjögren’s syndrome patients categorised by serological profiles: clinical and immunological characteristics

Kontny¹,

Lewandowska-Poluch²,

Chmielińska³

et al. 2018

Reumatologia

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“…Treatment with antirheumatic drugs was shown to be effective in some SS patients. However, this systemic approach causes side effects, has minimal impact on salivary gland function, and is effective only in subgroups of SS patients [ 12 , 13 ]. Thus, other approaches are necessary to improve saliva flow and prevent salivary gland degeneration in SS patients.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Visualization and Treatment of Salivary Gland Dysfunction in Sjögren’s Syndrome Patients Using Contrast-Enhanced Ultrasound Sialendoscopy (CEUSS)

Karagozoglu,

Mahraoui,

Bot

et al. 2023

JCM

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In sialendoscopy, ducts are dilated and the salivary glands are irrigated with saline. Contrast-enhanced ultrasound sialendoscopy (CEUSS), using microbubbles, may facilitate the monitoring of irrigation solution penetration in the ductal system and parenchyma. It is imperative to test CEUSS for its safety and feasibility in Sjögren’s syndrome (SS) patients. CEUSS was performed on 10 SS patients. The primary outcomes were safety, determined by the occurrence of (serious) adverse events ((S)AEs), and feasibility. The secondary outcomes were unstimulated and stimulated whole saliva (UWS and SWS) flow rates, xerostomia inventory (XI), clinical oral dryness score, pain, EULAR Sjögren’s syndrome patient reported index (ESSPRI), and gland topographical alterations. CEUSS was technically feasible in all patients. Neither SAEs nor systemic reactions related to the procedure were observed. The main AEs were postoperative pain (two patients) and swelling (two patients). Eight weeks after CEUSS, the median UWS and SWS flow had increased significantly from 0.10 to 0.22 mL/min (p = 0.028) and 0.41 to 0.61 mL/min (p = 0.047), respectively. Sixteen weeks after CEUSS, the mean XI was reduced from 45.2 to 34.2 (p = 0.02). We conclude that CEUSS is a safe and feasible treatment for SS patients. It has the potential to increase salivary secretion and reduce xerostomia, but this needs further investigation.

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“…Another important point to mention is that in the TRACTISS study,8 the effect of rituximab treatment on the histopathology of the glandular tissue itself has not been studied, nor is any information given about how many patients had a positive salivary gland biopsy at the start of the study. Because of this, it is impossible to make a statement about whether or not the right subgroup of patients was included in the first place, to detect changes in TUS, as it appears that rituximab shows efficacy in a subgroup of patients with pSS 16…”

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confidence: 99%

Can ultrasound of the major salivary glands assess histopathological changes induced by treatment with rituximab in primary Sjögren’s syndrome?

et al. 2018

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Editorial: Rituximab in the Treatment of Sjögren's Syndrome: Is It the Right or Wrong Drug?

Cited by 16 publications

References 25 publications

Subgroups of Sjögren’s syndrome patients categorised by serological profiles: clinical and immunological characteristics

Subgroups of Sjögren’s syndrome patients categorised by serological profiles: clinical and immunological characteristics

Intraoperative Visualization and Treatment of Salivary Gland Dysfunction in Sjögren’s Syndrome Patients Using Contrast-Enhanced Ultrasound Sialendoscopy (CEUSS)

Can ultrasound of the major salivary glands assess histopathological changes induced by treatment with rituximab in primary Sjögren’s syndrome?

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