Effekt liposomaler Lokaltherapie auf die Sicca-Symptomatik des primären Sjögren-Syndroms

Abstract

Primary Sjögren's syndrome (pSS) represents the most common rheumatologic disease in the head and neck area. Due to various nonspecific symptoms, many different medical specialities are involved in diagnostic and therapeutic regimes of patients with pSS. Therefore broad knowledge of symptoms and therapeutic options is important. Effective management of xerostomia, keratoconjunctivis sicca (KCS), and rhinitis sicca (RS) is essential in every patient to alleviate symptoms and prevent local complications. Various substitutes with different ingredients are available for topical and symptomatic therapy, but there are no generally accepted treatment suggestions due to the lack of studies proving effective relief of symptoms. Between October 2007 and August 2012, pSS was diagnosed in 73patients according to the American European Consensus Group (AECG) criteria. Before and after a 2-month period of treatment with liposomal agents for oral, nasal, and ocular complaints (LipoSaliva®, LipoNasal®, and Tears Again®,) AECG criteria and subjective symptoms were evaluated using visual analogue scales. Xerostomia (92 %), KCS (92 %), and recurrent salivary gland swelling (40 %) were the leading clinical symptoms. Mean salivary flow rate was 1.89g (Saxon test), mean lacrimal flow 12.7mm (SchirmerI test). SS-A and -B antibodies could be detected in 47patients (29 %). An average histologic focus score of 3 was assigned (Chisholm and Mason). Extraglandular manifestations were observed in 17 %, while severe local complications due to ineffective treatment of sicca symptoms were diagnosed in 70.5 %. Liposomal local therapy caused a significant reduction of xerostomia (p = 0.0001), KCS (p = 0.004), and RS (p = 0.004). Local therapy with liposomal agents is effective in the symptomatic treatment of xerostomia, KCS, and RS in patients with pSS.