Relief from Sjögren's? Not With This Arthritis Rx

Rituximab did not relieve Sjogren syndrome symptoms or disease activity

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Sjögren’s syndrome is an autoimmune disease that causes dry mouth and dry eyes. A recent study tested whether Sjögren’s patients would respond to a medication sometimes used for other autoimmune disorders.

Researchers administered either rituximab (Rituxan) or fake medicine to a group of patients with Sjögren’s syndrome.

These researchers found that the rituximab group had improved symptoms after six weeks. However, after 24 weeks, both groups' symptoms were similar.

The authors of this study concluded that rituximab did not alleviate symptoms or disease activity of Sjögren’s syndrome after 24 weeks.

"Talk to your pharmacist about treatment options for Sjögren’s syndrome."

Alain Saraux, MD, PhD, of the Rheumatology Unit in the Hopital de la Cavale Blanche, led this study.

Primary Sjögren’s syndrome is a disorder in which the immune system attacks tear glands and saliva glands. The most common symptoms of this condition are dry eyes and dry mouth.

Rituximab is a medication that destroys B cells and is sometimes used in autoimmune disorders like rheumatoid arthritis.

This trial investigated whether rituximab would be effective in treating primary Sjögren’s syndrome.

Dr. Saraux and colleagues recruited 120 patients from 14 hospitals in France to participate in this trial. Each of these participants had active primary Sjögren’s syndrome and were 18 years old or older.

A total of 63 of the patients received a dose of rituximab at the beginning of the study and two weeks later. The other patients received a placebo (fake medicine).

The researchers evaluated the participants six weeks, 16 weeks and 24 weeks after the first dose. They looked for an improvement in disease activity, pain, fatigue and dryness.

Compared to the participants taking placebos, about 13 percent more of the rituximab group saw symptom improvements at week six.

By week 24, 22 percent of the placebo group and 23 percent of the rituximab group had experienced improvements in at least two of their symptoms.

According to Dr. Saraux and team, the difference between the two groups was not significant enough to conclude that rituximab was effective at improving symptoms in the long term.

The researchers also found that rituximab did not alleviate pain at any of the follow-up periods.

Five patients in the rituximab group experienced a reaction after the first infusion, while only one patient in the placebo group did.

Additionally, seven patients taking rituximab reported a respiratory symptom, such as throat irritation, in the 24 hours after taking the medication.

The researchers concluded that rituximab was not tied to significant improvements in symptoms of primary Sjögren’s syndrome after 24 weeks. However, the medication did lead to improvements at week six, suggesting that it may have short-term effectiveness that goes away with time.

The authors of this study also noted that fatigue was the Sjögren’s symptom that rituximab improved the most.

This study was published in the Annals of Internal Medicine on February 17.

The research was supported by the Programmed Hospitalie de Recherche Clinique 2010, and the rituximab was donated by Roche. The authors did not disclose conflicts of interest.

Review Date: 
February 13, 2014
Last Updated:
February 18, 2014