Abstract
Objective. To evaluate the effects of non-pharmacological interventions for primary SS (pSS) on outcomes falling within the World Health Organization International Classification of Functioning Disability and Health domains.Methods. We searched the following databases from inception to September 2014: Cochrane Database of Systematic Reviews; Medline; Embase; PsychINFO; CINAHL; and clinical trials registers. We included randomized controlled trials of any non-pharmacological intervention. Two authors independently reviewed titles and abstracts against the inclusion/exclusion criteria and independently assessed trial quality and extracted data.Results. A total of 1463 studies were identified, from which 17 full text articles were screened and 5 studies were included in the review; a total of 130 participants were randomized. The included studies investigated the effectiveness of an oral lubricating device for dry mouth, acupuncture for dry mouth, lacrimal punctum plugs for dry eyes and psychodynamic group therapy for coping with symptoms. Overall, the studies were of low quality and at high risk of bias. Although one study showed punctum plugs to improve dry eyes, the sample size was relatively small.Conclusion. Further high-quality studies to evaluate non-pharmacological interventions for PSS are needed.
Highlights
Primary SS is a systemic autoimmune disease primarily affecting exocrine glands, resulting in dry eyes and dry mouth [1]
The included studies investigated the effectiveness of an oral lubricating device for dry mouth, acupuncture for dry mouth, lacrimal punctum plugs for dry eyes and psychodynamic group therapy for coping with symptoms
We identified no evidence to support any non-pharmacological interventions to improve primary SS
Summary
Primary SS (pSS) is a systemic autoimmune disease primarily affecting exocrine glands, resulting in dry eyes and dry mouth [1]. It has a female preponderance [2], and a recent meta-analysis has identified a prevalence rate of 74/100 000 inhabitants [2], using the AmericanEuropean Consensus Criteria [3].
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