Hydroxychloroquine improves dry eye symptoms of patients with primary Sjogren’s syndrome

Abstract

The objective of the study is to investigate the effect of hydroxychloroquine (HCQ) on subjective and objective parameters of dry eye in patients with primary Sjogren's disease and to evaluate the association of tear fluid B-cell activating factor (BAFF) level with the response. Thirty-two patients with primary Sjogren's disease were enrolled in this prospective study. All patients included in the study completed at least a 48-month run-in period of using hydroxychloroquine. Patients were then instructed to drop the treatment for 3 months. Baseline and post cessation of treatment (baseline and 3 months) evaluations included, subjective symptom scoring, fluorescein and lissamine green staining, Schirmer's test, tear break-up time (BUT) and tear fluid BAFF assessments. Significant worsening was observed in, tear break up-time (TBUT) (7.9 ± 3.4 vs. 5.9 ± 2.9, P < 0.001) lissamine green of staining of the ocular surface (1.3 ± 0.9 vs. 1.8 ± 0.8, P < 0.01) and corneal fluorescein staining scores (2.2 ± 2.1 vs. 4.6 ± 3.3, P < 0.003) between on and off HCQ treatment, respectively. Similarly, gritty sensation and burning sensation were significantly changed at week 12 compared to baseline evaluation (1.18 ± 1.02 vs. 1.7 ± 1.05, P < 0.007 and 1.1 ± 1.0 vs. 1.6 ± 1.2, P < 0.0, respectively). Disease duration significantly correlated with baseline OSDI (r = 0.38, P < 0.04) and the average daily use of artificial tears (r = 0.36, P < 0.04). The mean BAFF levels were 0.8 ± 0.5 and 4.0 ± 0.7 ng/ml for baseline and week 12 evaluation, respectively (P < 0.0001). The results of this study suggest that HCQ may alleviate symptoms and signs of dry eye in pSS and decreases tear fluid BAFF levels.

Evaluation of possible factors affecting contrast sensitivity function in patients with primary Sjögren’s syndrome

“…In this current study, although none of the participants were using ar tificial tears, there were no significant differences between the pSS group and control group either in terms of CS tests measured at all spatial frequencies or in terms of total, coma-like, and spherical-like HOAs. These similar results may be attributed to the use of HQ in pSS patients, because the alleviating effect of HQ (reducing the levels of BAFF in the tear fluid of pSS patients) has been demonstrated in a previous study (29) . In another study, the beneficial effect of HQ on xerostomia has also been demonstrated in pSS patients (30) .…”

Ocular Involvement in Sjögren’s Syndrome: Advances in Therapy

“…There was a statistically significant worsening of tear break up time, Schirmer 1 scores, and corneal and conjunctival staining [32]. Additionally, patients became symptomatic with respect to ocular sensations including gritty and burning sensations.…”

Hydroxychloroquine Reverses Alopecia in Autoimmune Polyendocrinopathy- Candidiasis-Ectodermal Dystrophy (APECED): A Case Report

“…The drug is reported to improve salivary gland function and oral moisture in some studies [13][14][15] to decrease dry eyes, [16] and to have no effect on disease manifestations in others [17]. A recent case report describes the efficacy of HCQ in two patients with alopecia totalis [18].…”