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New Developments in Sjogren's Syndrome
Dry Eye Therapies under Investigation for Sjogren's Syndrome
- Cevimeline (Evoxac), a drug that has already been approved by the U.S. Food and Drug Administration (FDA) for the treatment of dry mouth, is also being evaluated as a potentially safe and effective treatment for dry eye.
- Topical therapy with cyclosporin A is being evaluated for the treatment of dry eye.
- Novel topical agents that are designed to enhance the transport of water across the conjunctiva by stimulating specific receptors in the eye known as purinogenic ocular surface receptors are being developed for the treatment of dry eye.
- Eye-drops formulated with hyaluronate show promise for the treatment of severe dry eye in Sjogren's patients.
Novel secretogogues that target secretion of mucins which form the inner layer of the tear film and are responsible for lubrication and protection including:
- diquafosol tetrasodium (INS365) - improved test scores of Schirmer test and corneal/conjunctival staining
- 15S-HETE
- ecabet sodium (Rebamipide) -- this showed an improvement in objective and subjective reports of dry eye in a small randomized trial
- gefarnate
Gene transfer of therapeutic agents (such as immunomodifying agents) into the affected gland has successfully been studied in animals. Researchers are investigating the potential of carrying out this model for treatment in humans.
- There is ongoing effort to produce saliva substitutes based on new thickening agents such as linseed polysaccharide or xanthan gum polysaccharide to achieve longer adherence on mucosal surfaces.
- Researchers are studying a treatment involving irrigation of the parotid gland with prednisolone.
- Efforts are underway to reformulate pilocarpine as a slow release medication that will deliver medication at a slow, steady rate over a longer period of time than the present form.
- Researchers in Japan studied the rate of recurrence of dry eye in 53 patients with Sjogren's syndrome who received topical methylprednisolone eyedrops 4 times a day for two weeks and were tapered off of the medication slowly at two week intervals. Recurrence rate of dry eyes was very low. To read more about this treatment, please click on the following link: http://www.medifocus.com/abstracts.php?gid=RH011&ID=17341155
