Experimental therapies in primary Sjögren’s syndrome

Abstract

Recently there has been a large increase in the number of clinical trials assessing systemic immunomodulatory drugs in Sjögren’s syndrome. This has occurred for a number of reasons including a growing appreciation of the direct and indirect costs and quality-of-life impairment associated with Sjögren’s syndrome, as well as the development of validated outcome measures. Early studies with antitumour necrosis factor demonstrated that a greater understanding of the pathogenic role of a putative target is required since some typically proinflammatory cytokines may also have a negative regulatory role in a context-dependent fashion. Despite the disappointing results of two phase 3 studies of rituximab, novel approaches to B-cell depletion are currently being studied, alongside trials targeting IL-6, intracellular signalling, and co-stimulation pathways.