TY - JOUR
T1 - Toward better outcomes in Sjögren's syndrome
T2 - The promise of a stratified medicine approach
AU - Noaiseh, Ghaith
AU - Baer, Alan N.
N1 - Funding Information:
Dr. Baer was supported by the Jerome L. Greene Foundation and the NIH/National Heart Lung and Blood Institute (contract 75N2019Q0198).This study was supported by the Jerome L. Greene Foundation.
Funding Information:
Dr. Baer was supported by the Jerome L. Greene Foundation and the NIH/National Heart Lung and Blood Institute (contract 75N2019Q0198 ).
Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2020/2
Y1 - 2020/2
N2 - Sjögren's syndrome is a systemic autoimmune disease defined by its targeted inflammation of the salivary and lacrimal glands, resulting in dry mouth and eyes in the majority and persistent or recurrent salivary gland enlargement in a minority of those affected. Involvement of major organs, an increased risk of lymphoma, and autoantibodies against ubiquitous cellular ribonucleoproteins define some of its systemic features. Those affected have a high symptom burden and the development of disease-modifying therapies is thus an urgent need. A stratified medicine approach offers promise as a means of targeting specific therapies to patients for whom the mechanism of action is most relevant. Implementation of this approach will require an understanding of the pathophysiological processes underlying different patient subsets, and then identifying or developing a drug that targets this pathway. Such therapies would be most effective if implemented early in the disease course before the advent of adverse outcomes or glandular damage. This review will provide a disease overview followed by an analysis of the feasibility of a stratified medicine approach, focusing on the disease heterogeneity, predictors of disease progression and adverse outcomes, and recent advances in the development of relevant outcome measures and new therapies.
AB - Sjögren's syndrome is a systemic autoimmune disease defined by its targeted inflammation of the salivary and lacrimal glands, resulting in dry mouth and eyes in the majority and persistent or recurrent salivary gland enlargement in a minority of those affected. Involvement of major organs, an increased risk of lymphoma, and autoantibodies against ubiquitous cellular ribonucleoproteins define some of its systemic features. Those affected have a high symptom burden and the development of disease-modifying therapies is thus an urgent need. A stratified medicine approach offers promise as a means of targeting specific therapies to patients for whom the mechanism of action is most relevant. Implementation of this approach will require an understanding of the pathophysiological processes underlying different patient subsets, and then identifying or developing a drug that targets this pathway. Such therapies would be most effective if implemented early in the disease course before the advent of adverse outcomes or glandular damage. This review will provide a disease overview followed by an analysis of the feasibility of a stratified medicine approach, focusing on the disease heterogeneity, predictors of disease progression and adverse outcomes, and recent advances in the development of relevant outcome measures and new therapies.
KW - Biomarkers
KW - Disease-modifying therapy
KW - Personalized medicine
KW - Sjögren's syndrome
KW - Stratified medicine
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U2 - 10.1016/j.berh.2019.101475
DO - 10.1016/j.berh.2019.101475
M3 - Review article
C2 - 32005417
AN - SCOPUS:85078430816
SN - 1521-6942
VL - 34
JO - Best Practice and Research: Clinical Rheumatology
JF - Best Practice and Research: Clinical Rheumatology
IS - 1
M1 - 101475
ER -