Title |
How are we treating our systemic patients with primary Sjögren syndrome? Analysis of 1120 patients
|
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Published in |
International Immunopharmacology, April 2015
|
DOI | 10.1016/j.intimp.2015.03.027 |
Pubmed ID | |
Authors |
H. Gheitasi, B. Kostov, R. Solans, G. Fraile, C. Suárez-Cuervo, A. Casanovas, F.J. Rascón, R. Qanneta, R. Pérez-Alvarez, M. Ripoll, M. Akasbi, B. Pinilla, J.A. Bosch, J. Nava-Mateos, B. Díaz-López, M.L. Morera-Morales, S. Retamozo, M. Ramos-Casals, P. Brito-Zerón, Autoimmune Diseases Study Group on behalf of the SS Study Group |
Abstract |
To describe how systemic disease is treated in a large cohort of Spanish patients with primary Sjögren syndrome (pSS) in daily practice, focusing on the adequacy of therapies for the level of systemic activity measured by ESSDAI score. By December 2014, our database included 1120 consecutive patients who fulfilled the 2002 classification criteria for SS. Therapeutic schedules were classified into 4 categories: no systemic therapies, hydroxychloroquine (HCQ) and/or low dose glucocorticoids (GCS) (<20mg/day), high dose GCS (>20mg/day) and use of second-line therapies (immunosuppressive agents, intravenous immunoglobulins [IVIG] and/or rituximab [RTX]). There were 1048 (94%) females and 72 (6%) males, with a mean age at diagnosis of 54 years. The main drug-based therapeutic approaches for systemic pSS during follow-up were HCQ in 282 (25%) patients, GCS in 475 (42%, at doses >20mg/day in 255-23%), immunosuppressive agents in 148 (13%), IVIG in 25 (2%) and RTX in 35 (3%) patients. HCQ was associated with a lower risk of death (adjusted HR of 0.57, 95% 0.34-0.95). We classified 16 (7%) of the 255 patients treated with >20mg GCS and 21/148 (14%) treated with immunosuppressive agents, patients as inadequately treated, mainly associated with articular involvement of low/moderate activity. The management of pSS should be organ-specific, using low dose GCS in patients with moderate systemic activity, limiting the use of high dose GCS and second-line therapies to refractory or potentially severe scenarios. The use of systemic therapies for dryness, chronic pain or fatigue is not warranted. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Spain | 1 | 100% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Japan | 1 | 1% |
Spain | 1 | 1% |
Unknown | 74 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 10 | 13% |
Student > Ph. D. Student | 10 | 13% |
Student > Master | 10 | 13% |
Researcher | 8 | 11% |
Student > Bachelor | 6 | 8% |
Other | 14 | 18% |
Unknown | 18 | 24% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 39 | 51% |
Psychology | 3 | 4% |
Biochemistry, Genetics and Molecular Biology | 3 | 4% |
Immunology and Microbiology | 2 | 3% |
Agricultural and Biological Sciences | 1 | 1% |
Other | 4 | 5% |
Unknown | 24 | 32% |