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Aktuelle therapeutische Optionen bei Sjögren-Syndrom

Current therapeutic options in Sjögren’s syndrome

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Zusammenfassung

Das Sjögren-Syndrom ist eine systemisch-entzündlich-rheumatische Erkrankung mit bislang unklarer Genese und daher weiterhin begrenzten therapeutischen Möglichkeiten. Die Behandlung der Sicca-Symptome erfolgt symptomatisch. Extraglanduläre Manifestationen können den Einsatz von Kortikosteroiden, NSAR und/oder Immunsuppressiva erfordern. Die Studienlage ist hier allerdings unzureichend. Neue Erkenntnisse zur Pathogenese des Krankheitsbildes ermöglichen die Entwicklung neuer gezielterer Therapieansätze. So zeigten B-Zell-gerichtete Therapien z. T. hoffnungsvolle Ergebnisse. In Pilotstudien konnte die Wirksamkeit einer B-Zell-Depletion mittels Rituximab bei Sjögren-Syndrom, mit oder ohne B-Zell-Non-Hodgkin-Lymphom, nachgewiesen werden. Größere kontrollierte Studien sowie verlässliche Outcome-Kriterien sind hier erforderlich. Weitere Therapieansätze für das Sjögren-Syndrom befinden sich derzeit in Entwicklung bzw. in früher klinischer Testung.

Abstract

Sjögren’s syndrome is a systemic inflammatory-rheumatic disorder of hitherto unknown origin and, hence, adequate therapy options are not available in most cases. Treatment of sicca symptoms in Sjögren’s patients is primarily symptomatic. Glucocorticoids, NSAIDs and/or immunosuppressive drugs may be used for the treatment of extraglandular manifestations or complications. Although there have been few clinical studies to date, new insights into the pathogenesis of this disorder may permit novel therapeutic strategies. Targeting B-cell candidates as a new therapeutic option in this entity has shown promising results. B-cell-depletion using Rituximab has been tested in initial clinical trials for the treatment of Sjögren patients, both with and without associated B-cell non-Hodgkin-lymphoma; however, further studies as well as reliable outcome criteria are needed. Further therapeutic options are currently in development or early clinical testing.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Thomas Dörner hat Vortragshonorare durch die Fa. Roche Pharma AG, Deutschland, sowie finanzielle Unterstützung zur Durchführung von klinischen Studien durch die Fa. Immunomedics Inc. erhalten.

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Authors and Affiliations

  1. Park-Klinik Weißensee, Akademisches Lehrkrankenhaus der Charité, Schönstr. 80, 13086, Berlin, Deutschland

    A. Hansen

  2. Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Deutschland

    T. Dörner

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  1. A. Hansen
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  2. T. Dörner
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Correspondence to A. Hansen.

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Hansen, A., Dörner, T. Aktuelle therapeutische Optionen bei Sjögren-Syndrom. Z. Rheumatol. 69, 19–24 (2010). https://doi.org/10.1007/s00393-009-0515-6

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