Effect of Systemic Infliximab Therapy in Patients with Sjögren’s Syndrome

Abstract

Objectives:To investigate the effect of systemic infliximab therapy on tear function tests and the ocular surface in patients with Sjögren’s syndrome secondary to various autoimmune diseases.Ma­te­ri­als and Met­hods:This prospective study included 22 eyes of 22 patients with Sjögren’s syndrome who began treatment with systemic infliximab. Tear film break-up time (TBUT), anesthetized Schirmer’s 1 test, fluorescein staining test, and Ocular Surface Disease Index (OSDI) scores were recorded before treatment and in the 3rd and 6th months of treatment.Re­sults:In the 3rd month of infliximab therapy, no significant changes were observed in Schirmer’s values, TBUT, fluorescein staining, or OSDI scores (p=0.260, p=0.357, p=0.190 and p=0.07, respectively). In the 6th month of infliximab therapy, no significant changes were observed in TBUT, fluorescein staining, Schirmer’s value or OSDI scores (p=0.510, p=0.320, p=0.220 and p=0.344, respectively).Conclusion:Infliximab therapy, which is commonly used in systemic autoimmune diseases such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and ankylosing spondylitis, did not show a positive effect on ocular surface and tear function tests.

Exploiting the role of T cells in the pathogenesis of Sjögren’s syndrome for therapeutic treatment

“…Infliximab and etanercept, which both target TNF-α, have been shown to improve ocular fatigue symptoms, but were ineffective in patients with dry eyes and dry mouth. Currently, a multicenter phase II clinical trial of infliximab is underway, but so far, xerosis symptoms and the degree of salivary gland infiltration were not improved and there were serious adverse reactions, such as transfusion reaction, autoimmune liver disease, and pneumococcal septicemia ( 127 ). In a clinical trial of subcutaneously applied etanercept in 15 SS patients, the salivary and lacrimal gland functions were not significantly improved, and some individuals had local side effects ( 128 ).…”

Management of Sjogren’s Dry Eye Disease—Advances in Ocular Drug Delivery Offering a New Hope

“…Several other agents have been studied in SS, but not necessarily in relation to dry eye. This includes anti-inflammatory agents infliximab and etanercept, which target TNF-a, and anakinra, an IL-1 antagonist [ 50 , 51 ]. Tocilizumab, an IL-6 receptor agonist, showed no impact on immunoglobulins, complement, or systemic disease activity, which suggested that IL-6 may not be a main contributor to peripheral B-cell activation in SS [ 52 ].…”