Treatment of Primary Sjögren Syndrome With Rituximab
Authors: Denise L. Faustman, Frederick B. Vivino, Steven E. Carsons
Journal: Annals of Internal Medicine (2014)

Letters2 September 2014Treatment of Primary Sjögren Syndrome With RituximabDenise L. Faustman, MD, PhD, Frederick B. Vivino, MD, and Steven E. Carsons, MDDenise L. Faustman, MD, PhDFrom Harvard Medical School, Boston, Massachusetts; Penn Presbyterian Medical Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania; and Winthrop-University Hospital Campus, Stony Brook University School of Medicine, Mineola, New York., Frederick B. Vivino, MDFrom Harvard Medical School, Boston, Massachusetts; Penn Presbyterian Medical Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania; and Winthrop-University Hospital Campus, Stony Brook University School of Medicine, Mineola, New York., and Steven E. Carsons, MDFrom Harvard Medical School, Boston, Massachusetts; Penn Presbyterian Medical Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania; and Winthrop-University Hospital Campus, Stony Brook University School of Medicine, Mineola, New York.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5017-3 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Devauchelle-Pensec and colleagues (1) conclude that their data do not support the use of rituximab in most patients with recent-onset or systemic primary Sjögren syndrome (pSS). We agree that the best outcome measure for assessing treatment efficacy in pSS is debatable.The European League Against Rheumatism Sjögren's Syndrome Disease Activity Index (ESSDAI) is a major step toward the development of standardized outcome measures for pSS but does not incorporate assessments of dryness. The ESSDAI was responsive to disease activity in patients with pSS treated with rituximab (2) when examined in a prospective single-center trial. However, this index ...References1. Devauchelle-Pensec V, Mariette X, Jousse-Joulin S, Berthelot JM, Perdriger A, Puéchal X, et al. Treatment of primary Sjögren syndrome with rituximab: a randomized trial. Ann Intern Med. 2014;160:233-42. [PMID: 24727841] LinkGoogle Scholar2. Meiners PM, Arends S, Brouwer E, Spijkervet FK, Vissink A, Bootsma H. Responsiveness of disease activity indices ESSPRI and ESSDAI in patients with primary Sjögren's syndrome treated with rituximab. Ann Rheum Dis. 2012;71:1297-302. [PMID: 22258489] doi:10.1136/annrheumdis-2011-200460 CrossrefMedlineGoogle Scholar3. Meijer JM, Meiners PM, Vissink A, Spijkervet FK, Abdulahad W, Kamminga N, et al. Effectiveness of rituximab treatment in primary Sjögren's syndrome: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2010;62:960-8. [PMID: 20131246] doi:10.1002/art.27314 CrossrefMedlineGoogle Scholar4. Pers JO, Devauchelle V, Daridon C, Bendaoud B, Le Berre R, Bordron A, et al. BAFF-modulated repopulation of B lymphocytes in the blood and salivary glands of rituximab-treated patients with Sjögren's syndrome. Arthritis Rheum. 2007;56:1464-77. [PMID: 17469105] CrossrefMedlineGoogle Scholar5. Carubbi F, Cipriani P, Marrelli A, Benedetto P, Ruscitti P, Berardicurti O, et al. Efficacy and safety of rituximab treatment in early primary Sjögren's syndrome: a prospective, multi-center, follow-up study. Arthritis Res Ther. 2013;15:R172. [PMID: 24286296] doi:10.1186/ar4359 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Denise L. Faustman, MD, PhD; Frederick B. Vivino, MD; Steven E. Carsons, MDAffiliations: From Harvard Medical School, Boston, Massachusetts; Penn Presbyterian Medical Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania; and Winthrop-University Hospital Campus, Stony Brook University School of Medicine, Mineola, New York.Note: The authors are members of the Sjögren's Syndrome Foundation Medical and Scientific Advisory Board.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0206. 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