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2017 ; 18
(1
): 186
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Is hydroxychloroquine effective in treating primary Sjogren s syndrome: a
systematic review and meta-analysis
#MMPMID28499370
Wang SQ
; Zhang LW
; Wei P
; Hua H
BMC Musculoskelet Disord
2017[May]; 18
(1
): 186
PMID28499370
show ga
BACKGROUND: To systematically review and assess the efficacy and safety of
hydroxychloroquine (HCQ) for treating primary Sjogren's syndrome (pSS). METHODS:
Five electronic databases (Pubmed, EMBASE, Web of science, Ovid, Cochrane
Library) were searched for randomized controlled trials and retrospective or
prospective studies published in English that reported the effect of HCQ on pSS.
The subjective symptoms (?sicca symptoms, fatigue and pain) and the objective
indexes (erythrocyte sedimentation rate and Schirmer test) were assessed as main
outcome measures. A meta-analysis and descriptive study on the efficacy and
safety of HCQ were conducted. The estimate of the effect of HCQ treatment was
expressed as a proportion together with 95% confidence interval, and plotted on a
forest plot. RESULTS: Four trials with totals of 215 SS patients, including two
randomized controlled trials, one double blind crossover trial and one
retrospective open-label study, were analyzed in this review. For dry mouth and
dry eyes, the effectiveness of HCQ treatment was essentially the same as placebo
treatment. For fatigue, the effectiveness of HCQ was lower than placebo. The
efficacy of HCQ in treating pain associated with pSS was superior to that of the
placebo. There was no significant difference between HCQ-treated groups and
controls in terms of Schirmer test results, but HCQ could reduce the erythrocyte
sedimentation rate compare with placebo. A descriptive safety assessment showed
that gastrointestinal adverse effects were the most common adverse effects
associated with HCQ. CONCLUSIONS: This systematic review showed that there is no
significant difference between HCQ and placebo in the treatment of dry mouth and
dry eye in pSS. Well-designed, randomized, controlled trials are needed to
provide higher-quality evidence to confirm our findings, and future studies
should focus on some other ?i?n?dex ?or? extraglandular measures, such as
cutaneous manifestations, to further explore the therapeutic effect of HCQ in
pSS.
|Antirheumatic Agents/*therapeutic use
[MESH]
|Humans
[MESH]
|Hydroxychloroquine/*therapeutic use
[MESH]
|Prospective Studies
[MESH]
|Randomized Controlled Trials as Topic/methods
[MESH]