Treatment of sicca symptoms with hydroxychloroquine in patients with Sjogren's syndrome.

Abstract

OBJECTIVE:

There is no established disease-modifying treatment of xerostomia and xerophthalmia in SS. This retrospective study was performed in order to evaluate the efficacy of HCQ for glandular function, i.e. saliva and tear production.

METHODS:

Fourteen patients with primary SS (pSS) were included (Group A). All patients were anti-Ro and/or -La antibody positive except one. Patients were treated with HCQ for a period of up to 6 months. Glandular function was determined by Saxon's and Schirmer's tests for the dominant eye at baseline and at the end of the treatment. We included a control group of 21 patients with objective sicca symptoms and positive alpha-fodrin antibodies (Group B).

RESULTS:

In patients with pSS (Group A), a significant increase in saliva production after HCQ treatment (P = 0.022) was observed. A subanalysis revealed that particularly the alpha-fodrin-positive patients responded to HCQ (P = 0.017 alpha-fodrin positive vs P = 0.4 alpha-fodrin negative). Interestingly, patients with sicca symptoms and alpha-fodrin antibodies (Group B) showed a significant increase in tear production (P = 0.001). In addition, there was a positive correlation between the alpha-fodrin IgA antibody concentration and the Schirmer's test at baseline (r = 0.66; P = 0.001) and after treatment (r = 0.6; P = 0.004) in this group.

CONCLUSIONS:

HCQ treatment led to a beneficial effect on xerostomia in patients with pSS who lack severe organ manifestations. The response was greater in alpha-fodrin-positive patients.

• Authors: Markus Rihl, Kai Ulbricht, Reinhold E Schmidt, Torsten Witte
• Journal: Rheumatology (Oxford, England) (Rheumatology (Oxford)) Vol. 48 Issue 7 Pg. 796-9 (Jul 2009) ISSN: 1462-0332 [Electronic] England
• PMID: 19433433 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antirheumatic Agents
• Autoantibodies
• Carrier Proteins
• Immunoglobulin A
• Microfilament Proteins
• Rho Factor
• fodrin
• Hydroxychloroquine

Topics

• Adult
• Aged
• Aged, 80 and over
• Antirheumatic Agents (therapeutic use)
• Autoantibodies (blood)
• Carrier Proteins (immunology)
• Female
• Humans
• Hydroxychloroquine (therapeutic use)
• Immunoglobulin A (blood)
• Male
• Microfilament Proteins (immunology)
• Middle Aged
• Retrospective Studies
• Rho Factor (immunology)
• Sjogren's Syndrome (drug therapy, immunology)
• Statistics, Nonparametric
• Treatment Outcome
• Xerophthalmia (drug therapy, immunology)
• Xerostomia (drug therapy, immunology)