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

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Rheumatology Advance Access originally published online on May 11, 2009

Rheumatology 2009 48(7):796-799; doi:10.1093/rheumatology/kep104

Treatment of sicca symptoms with hydroxychloroquine in patients with

Sjögren's syndrome

Markus Rihl1, Kai Ulbricht1, Reinhold E. Schmidt1 and Torsten Witte1

1Clinic for Immunology and Rheumatology, Hannover Medical School

(MHH), Hannover, Germany.

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 -fodrin antibodies (Group .

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 -fodrin-positive patients

responded to HCQ (P = 0.017 -fodrin positive vs P = 0.4 -fodrin

negative). Interestingly, patients with sicca symptoms and -fodrin

antibodies (Group showed a significant increase in tear production

(P = 0.001). In addition, there was a positive correlation between the

-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 -fodrin-positive patients.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/48/7/796?etoc

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