infusions for Sjogren's help dry eye?

[spmcc]

Hello,

I am wondering if anyone with Sjogren's has had any infusions (e.g., rituximab or epratuzumab)? Has it helped with dry eye?

Thank you,
Sheila

[nycdryeyegirl]

Hello,

I am wondering if anyone with Sjogren's has had any infusions (e.g., rituximab or epratuzumab)? Has it helped with dry eye?

Thank you,
Sheila

Hi,

I hope you find the abstract below of an study involving four patients who had an acute severe dry eye condition that benefited from immunomodulatory treatment (i.e. prednisone,methotrexate, cyclosporine a and infliximab) helpful.

Pam



Systemic Immunomodulatory Therapy in Severe Dry Eye Secondary to Inflammation

Authors: Cordero-Coma, Miguel1; Anzaar, Fahd2; Sobrin, Lucia3; Foster, C. Stephen4

Source: Ocular Immunology and Inflammation, Volume 15, Number 2, March 2007 , pp. 99-104(6)

Publisher: Taylor and Francis Ltd

Abstract:
Purpose: To report four patients with unusually severe acute keratitis sicca secondary to lacrimal tissue and ocular surface inflammation who eventually required systemic immunosuppressive therapy. Methods: Observational case series of four patients with extremely severe acute dry eye syndrome who were profoundly disabled by pain and photophobia (to the extent of staying in dark rooms) despite aggressive conventional therapy. Clinical data including visual acuities, other treatments administered for dry eye, systemic medical conditions, Schirmer and rose bengal staining results, degree of conjunctival injection, and medications were recorded. All four patients were treated with systemic immunomodulatory therapy. Results: All four patients were female with a mean age at presentation of 40 years (range 22-58 years), and all had systemic autoimmune diseases: systemic lupus erythematosus (SLE) and Sjogren's syndrome (n = 2), Sjogren's syndrome (n = 1), rheumatoid arthritis (RA) and psoriasis (n = 1). Schirmer test values at onset ranged from 0 to 2 mm. All patients had failed aggressive lubrication, topical cyclosporine, lid care, and punctual plugs. In two patients, serum tears and hyphrecation punctal occlusion were tried without success. Various systemic immunosuppressive agents were used to control inflammation of the lacrimal glands: methotrexate and cyclosporine A (patient 1), cyclosporine A (patient 2), prednisone (patient 3), and methotrexate and infliximab (patient 4). Treatment with systemic immunomodulatory agents resulted in resolution of the acute inflammatory assault on the lacrimal glands and control of signs and symptoms of keratoconjunctivitis sicca in all four patients, and visual acuities improved in all of them. Post-treatment Schirmer values ranged from 7 to 10 mm. Conclusion: Systemic immunosuppressive agents may be required in the treatment of recalcitrant primary and secondary Sjogren's syndrome caused by systemic autoimmune conditions. We show that systemic immunomodulatory therapy leads to significantly improved tear production and resolution of the keratoconjunctivitis in these rare but severe cases.

[jenny2008]

i have never tried but since i dont have the arthritis component my Rheumy will not put me on any of these-he says they are not known to help dry eye and can cost around $1000 a month and have horrible side effects.. My eye specialist in Louisville pretty much told me the same thing.. just fyi... let me know if you find out anything different.. or if you find anyone who has gotten help.. i have been on sjogrens boards and no one has claimed the meds to have helped dry eyes..