Efficacy of Hydroxychloroquine in the treatment of primary Sjögren’s Syndrome: a systematic review
Main Article Content
Keywords
Sjogren's syndrome, Sicca, Hydroxychloroquine, Plaquenil
Abstract
Introduction: Hydroxychloroquine (HCQ) is commonly used in the treatment of primary Sjogren’s syndrome (pSS), although the evidence supporting its efficacy is limited and controversial. The aim of this systematic review (SR) is to evaluate the efficacy of HCQ in the treatment of pSS. Methods: Seven databases were reviewed, including studies in which HCQ was used as monotherapy, compared with placebo or other treatments. The objectives were to assess the improvement of subjective symptoms (dry eyes, dry mouth, fatigue, joint and muscle pain), objective ocular and oral signs, and systemic involvement. Laboratory markers such as immunoglobulins, erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF) were also considered. Results: Eight studies were included, three of which were randomized clinical trials (RCTs). The results did not show significant improvement in sicca symptoms or systemic involvement, except for a slight cardiovascular benefit reported in observational studies. A reduction in ESR, RF, IgG, and IgM was observed. Conclusions: This SR did not find sufficient evidence to support the use of HCQ in the treatment of pSS. Despite this, its widespread use in clinical practice is notable, highlighting the need for more well-designed RCTs.
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