Sjögren’s Syndrome Treatment
There is no cure for Sjögren’s syndrome. As with other autoimmune diseases, the severity of Sjögren’s varies from person to person. Many patients have a mild disease that only affects the eyes and mouth. Others have symptoms that wax and wane in severity, or may even go into remission. Some have severe and chronic (long-term) symptoms.
Current treatments focus on managing the symptoms. Moisture replacement therapies help relieve dryness and nonsteroidal anti-inflammatory drugs (NSAIDs) to control inflammation. People with severe Sjögren’s syndrome may receive corticosteroids, which mimic hormones that fight inflammation in the body, or disease-modifying antirheumatic drugs (DMARDs), which suppress the body’s immune response. In addition to a primary care physician, other members of the healthcare team may include a rheumatologist, an ophthalmologist and a dentist.
Here are some of the treatments and therapies for different areas of the body affected by Sjögren’s syndrome:
For Dry Mouth
Prescription medications that stimulate saliva flow include pilocarpine tablets or cevimeline capsules help treat symptoms of dry mouth by stimulating the salivary glands. The effects only last a few hours, so you may need to take several doses each day. People with asthma or narrow angle glaucoma should ask a doctor if it’s safe to take these medications.
Saliva substitutes or mouth-coating gels can be helpful, especially at night when the mouth becomes drier. These are available in sprays, liquids and pretreated swabs. Over-the-counter options include Glandosane, MedActive, MoiStir, MouthKote, Oasis, Optimoist, Oralube, Salivart and Xero-Lube. A doctor may also prescribe Aquoral mouth spray or NeutraSal mouth rinse.
For Dry Eyes
Some prescription eye drops or pellets can help keep eyes moist. Cyclosporine ophthalmic emulsion and hydroxypropyl cellulose pellets are slow-release tear pellets that may reduce the need for artificial tears. FreshKote artificial tears help redistribute moisture in damaged cells on the eyes’ surface. Some nonprescription artificial tears are Refresh, TheraTears and GenTeal. These products contain different ingredients and can be used individually or together. In more severe cases of dry eyes, the doctor may recommend a surgery called punctal occlusion. This operation keeps tears from draining out of your eyes and into the nose, helping the eyes keep their natural moisture.
For Dry Mouth, Throat and Upper Airways
Prescription medicines for these symptoms include cevimeline, pilocarpine, Linseed extract, Sorbitol or malic acid. They are available in a pill, liquid, and lozenge form. Using an expectorant such as guaifenesin may help with dryness of the throat and respiratory tract.
For Joint Pain
A doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen and naproxen, to decrease joint pain and stiffness and ease muscle aches. Disease-modifying antirheumatic drugs (DMARDs), such as hydroxychloroquine or methotrexate, may be prescribed for people to help relieve rashes, fatigue and joint pain. If the muscles, nerves, kidneys or lungs are affected, a doctor may recommend stronger DMARDs, corticosteroids, or medicines called azathioprine or cyclophosphamide.
For Oral Yeast Infection
A doctor may prescribe antifungal tablets or lozenges to treat this type of infection.
For Vaginal Dryness
Water-based vaginal lubricants (K-Y Jelly, Astroglide, Replens, Luvena) can ease vaginal dryness and painful intercourse. Estrogen creams or other preparations may be helpful for women who have vaginal dryness due to reduced estrogen levels related to menopause.