1. Is hydroxychloroquine effective in treating primary Sjogren’s syndrome: a systematic review and meta-analysis
- Author
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Shi-Qin Wang, Li-Wei Zhang, Pan Wei, and Hong Hua
- Subjects
0301 basic medicine ,medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,Cochrane Library ,Placebo ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Randomized controlled trial ,law ,Internal medicine ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Prospective Studies ,Adverse effect ,Randomized Controlled Trials as Topic ,Retrospective Studies ,030203 arthritis & rheumatology ,business.industry ,Therapeutic effect ,Hydroxychloroquine ,Crossover study ,stomatognathic diseases ,Meta-analysis ,030104 developmental biology ,Sjogren's Syndrome ,Treatment Outcome ,Antirheumatic Agents ,Physical therapy ,Systematic review ,Sjogren’s syndrome ,lcsh:RC925-935 ,business ,medicine.drug ,Research Article - Abstract
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. Electronic supplementary material The online version of this article (doi:10.1186/s12891-017-1543-z) contains supplementary material, which is available to authorized users.
- Published
- 2017
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