Assuntos
Tratamento Farmacológico da COVID-19 , Ciclosporina/uso terapêutico , Imunossupressores/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Síndrome da Liberação de Citocina/tratamento farmacológico , Síndrome da Liberação de Citocina/imunologia , Humanos , SARS-CoV-2/fisiologiaRESUMO
OBJECTIVE: To formulate SER recommendations for the use of biological agents in primary Sjögren's syndrome (pSS). METHODS: Relevant clinical research questions were identified on the use of biological agents in pSS. The clinical questions were reformulated into 4PICO questions. A search strategy was designed and a review of the scientific evidence of studies published until May 2017 was carried out. The scientific evidence available was systematically reviewed. The overall level of scientific evidence was assessed using the SIGN evidence levels. After that, specific recommendations were made. RESULTS: Rituximab is recommended as the biological agent of choice for extraglandular manifestations refractory to conventional treatment. The use of anti-TNF agents is discouraged. The scientific evidence with belimumab and abatacept is scarce, so they should be considered only in cases refractory to rituximab. CONCLUSIONS: Rituximab is the biological agent of choice in severe extraglandular manifestations of pSS. Belimumab or abatacept may be useful in selected cases.
Assuntos
Produtos Biológicos/uso terapêutico , Síndrome de Sjogren/tratamento farmacológico , Antirreumáticos/uso terapêutico , Humanos , Rituximab/uso terapêuticoRESUMO
PURPOSE: To report 2 cases of refractory idiopathic scleritis treated with rituximab. DESIGN: Interventional case series. METHODS AND RESULTS: Case 1: A 54-year-old woman, presented with anterior idiopathic scleritis in her right eye. Treatment with systemic steroids was not effective. Intravenous cyclophosphamide was discontinued after an adverse event. Case 2: A 43-year-old woman presented with idiopathic posterior scleritis in her left eye. Initial treatment with steroids was ineffective. In both cases, long-lasting remission without further relapses was achieved after 4 weekly doses (375 mg/m(2)) of rituximab. CONCLUSION: Rituximab was found to be an effective treatment for refractory idiopathic anterior and posterior scleritis.