Treatment of oral dryness in Sjogren's syndrome

Purpose. - In Sjogren's syndrome (SS), oral dryness is frequently the most bothersome symptom of sicca syndrome with negative effects on quality of life. A review of treatments of oral dryness is proposed. Current knowledge and key points. - To date, no specific DMARD has demonstrated its efficacy in SS. Hydroxychloroquine is frequently used but did not demonstrate any clinical benefit in the only small randomized control study versus placebo available. Thus, the only treatments are symptomatic. The most recent data show that systemic cholinergic agonists (pilocarpine and cevimeline) are effective in the symptomatic treatment of dryness. Pilocarpine (Salagen((R))) is the only systemic cholinergic agonist available in Europe. It has been agreed in France since July 2003. Future prospects and projects. - Use of immunosuppressive drugs may be useful in some complications of SS. Unfortunately, promising results from an open study with infliximab (Remicade((R))) were not confirmed by a large randomized control study involving more than 100 patients. New control studies with old drugs such as hydroxychloroquine, or new ones such as rituximab, are mandatory. (C) 2003 Elsevier SAS. Tous droits reserves.