Treatment strategies for Sjögren’s syndrome with childhood onset: a systematic review of the literature

Here is some of what was reported in the Rheumatology journal in 2021 regarding the treatments used for children who were diagnosed with Sjogren's syndrome.

The main treatment choices and clinical indications for which low-quality evidence for efficacy was available

Basically the review of the literature showed, that because Sjogren's syndrome in children is a rare diagnosis, better treatment recommendations are needed to treat children. Each specialist will trial treatments to see what works as there is no current clinical recommendations specifically for children with this autoimmune condition.

Treatment strategies for Sjögren’s syndrome with childhood onset: a systematic review of the literature.

Abstract

Objectives

SS with childhood onset is a rare autoimmune disease characterized by heterogeneous presentation. The lack of validated classification criteria makes it challenging to diagnose. Evidence-based guidelines for treatment of juvenile SS are not available due to the rarity of disease and the paucity of research in this patient population. This systematic review aims to summarize and appraise the current literature focused on pharmacological strategies for management of SS with childhood onset.

Methods

PubMed and MEDLINE/Scopus databases up to December 2020 were screened for suitable reports highlighting pharmacological treatment of SS with childhood onset. 

Results

A total of 43 studies (34 case reports, 8 mini case series and 1 pilot study) were eligible for analysis. The studies retrieved included girls in 88% (120/137) of cases and had very low confidence levels. 

HCQ was prescribed for parotid swelling, as well as in association with MTX and NSAIDs in patients with arthritis and arthralgia. Corticosteroids such as long courses of oral prednisone and i.v. methylprednisolone were commonly prescribed for children with severe disease presentations. Rituximab was mainly indicated for mucosa-associated lymphoid tissue lymphoma and renal and nervous system complications. Other conventional DMARDs were prescribed in selected cases with extra glandular manifestations.

Conclusion

Various therapies are used for the management of juvenile SS and are prescribed based on expert clinician’s opinion. There are currently no good-quality studies that allow clinical recommendations for treatment of SS with childhood onset.

You can read the full report of the treatments given here 

The authors of the review concluded: At present, there are no good-quality studies in SS with childhood onset to enable any clinical recommendations for strict selection of therapies. As the disease is rare in children compared with adults, further research into establishing validated classification criteria and disease outcome measures tailored for young people with SS is required.

SOURCE

Treatment strategies for Sjögren’s syndrome with childhood onset: a systematic review of the literature. 

Published

21 July 2021 in 

Rheumatology, British Society for Rheumatology.

Georgia Doolan, Nor Mohd Faizal, Charlene Foley, Muthana Al-Obaidi, Elizabeth C Jury, Elizabeth Price, Athimalaipet V Ramanan, Scott M Lieberman, Coziana Ciurtin