Sjögren’s syndrome is a chronic autoimmune disease where the immune system mistakenly attacks and damages the body’s moisture-producing glands, primarily those responsible for tears and saliva. This leads to common symptoms such as dry eyes and dry mouth. Beyond these hallmark symptoms, Sjögren’s syndrome can affect various organs and systems throughout the body, with symptoms and severity differing significantly among individuals.
Understanding Sjögren’s Treatment
There is no single “best” medicine for Sjögren’s syndrome, as treatment is highly individualized. The approach focuses on managing specific symptoms and addressing underlying immune system activity when necessary. Many people initially manage dry eye and dry mouth symptoms with over-the-counter remedies. However, some individuals require prescription medications or other procedures to alleviate discomfort or address broader systemic involvement. Treatment strategies often evolve over time, adapting to changes in symptoms or disease progression.
Managing Dry Eyes and Mouth
Treatments for dry eyes often begin with over-the-counter artificial tears and lubricating eye drops. For more persistent or severe dry eyes, prescription eye drops are available. Cyclosporine ophthalmic emulsions (e.g., Restasis, Cequa) reduce inflammation in tear glands, improving tear production. Lifitegrast ophthalmic solution (Xiidra) also reduces inflammation by blocking specific protein interactions. Additionally, punctal plugs can be inserted into tear ducts to block drainage, helping tears remain on the eye’s surface longer.
For dry mouth, common remedies include sipping water frequently, chewing sugar-free gum, or sucking on sugar-free candies to stimulate saliva flow. Over-the-counter saliva substitutes in spray or lozenge form can also provide relief. When these measures are insufficient, prescription medications can help increase saliva production. Pilocarpine (Salagen) and cevimeline (Evoxac) stimulate salivary glands to produce more saliva and can also increase tear production.
Addressing Systemic Manifestations
Beyond dry eyes and mouth, Sjögren’s syndrome can affect other parts of the body, leading to symptoms like joint pain, fatigue, skin rashes, or internal organ involvement. For joint pain, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be used. Hydroxychloroquine (Plaquenil) is often prescribed for general systemic symptoms, including joint pain, fatigue, and rashes, by calming the immune system.
For more severe systemic involvement or inflammation, immunosuppressants may be considered. Medications such as methotrexate or azathioprine suppress the immune system’s activity. These are typically reserved for cases with significant organ involvement or when other treatments are not effective. For very severe or organ-threatening disease, biologics like rituximab (Rituxan) or belimumab (Benlysta) may be used. These medications target specific immune pathways.
Navigating Your Treatment Journey
Managing Sjögren’s syndrome involves a collaborative approach with healthcare providers. A rheumatologist typically coordinates care, often working with ophthalmologists for eye issues and dentists for oral health. Regular monitoring is important to track symptom changes and assess treatment effectiveness.
Open communication with doctors about new symptoms or side effects is important. Treatment plans may need adjustments over time as the disease can progress variably. Adhering to prescribed medications and lifestyle modifications is important for managing the condition and improving quality of life.