O'Neill I D, Scully C
Centre d'Affaires Poincaré, Nice, France WHO Collaborating Centre for Oral Health-General Health, Oral Medicine, Bristol.
Oral Dis. 2013 Mar;19(2):121-7. doi: 10.1111/j.1601-0825.2012.01932.x. Epub 2012 Apr 12.
Oral Diseases (2012) doi:10.1111/j.1601-0825.2012.01932.x Biologic therapy has a potential to benefit patients with orofacial manifestations of Sjogren syndrome (SS). The most appropriate use of biologics would appear to be in patients with severe or multisystem features of SS, but their use early in the pathogenesis has the potential to prevent disease progression. Tumour necrosis factor-alpha blockade has not proven effective in SS. B-cell depletion using rituximab has been of benefit, mainly in relation to extraglandular features, and to some extent in relation to hyposalivation where there is still residual salivary function. Rituximab is also effective in the treatment of SS-associated (extrasalivary) lymphomas, although the therapeutic response in salivary lymphoma is poorer. Rituximab is given as a single or periodic intravenous infusion. Potential adverse effects exist, notably infusion reactions and infection, and so a full risk/benefit analysis is indicated for prospective patients. This and clinical use is best performed and monitored in conjunction with rheumatologists with appropriate training and experience in biologic therapies. Further studies of rituximab in SS are ongoing, and newer agents under trial include belimumab.
《口腔疾病》（2012年）doi:10.1111/j.1601-0825.2012.01932.x 生物疗法有可能使干燥综合征（SS）口腔面部表现的患者受益。生物制剂最恰当的应用似乎是在患有严重或多系统特征的SS患者中，但在发病机制早期使用它们有可能预防疾病进展。肿瘤坏死因子-α阻断在SS中尚未被证明有效。使用利妥昔单抗进行B细胞清除已显示出益处，主要与腺外表现有关，在某种程度上也与仍有残余唾液功能的唾液分泌减少有关。利妥昔单抗在治疗与SS相关的（唾液腺外）淋巴瘤方面也有效，尽管对唾液腺淋巴瘤的治疗反应较差。利妥昔单抗通过单次或定期静脉输注给药。存在潜在的不良反应，尤其是输注反应和感染，因此对于预期患者需要进行全面的风险/效益分析。这一点以及临床应用最好在有生物疗法适当培训和经验的风湿病学家的共同参与下进行并监测。利妥昔单抗在SS中的进一步研究正在进行中，正在试验的新型药物包括贝利木单抗。
