Table 2:

Therapeutic options for systemic features in Sjögren syndrome59,66,72,73

FeatureTherapy
Nonspecific symptoms
 Fatigue

  • Antidepressants, exercise

 Raynaud phenomenon

  • Avoidance of cold and stress; calcium-channel blockers

 Arthralgia, arthritis

  • Nonsteroidal anti-inflammatory drugs, hydroxychloroquine, methotrexate

Periepithelial involvement
 Interstitial nephritis-tubular dysfunction, renal tubular acidosis

  • Oral potassium and sodium carbonate

 Bronchial or bronchiolar involvement

  • Inhaled therapy

 Interstitial lung disease

  • Prednisolone, azathioprine

 Primary biliary cirrhosis

  • Ursodeoxycholic acid

 Autoimmune hepatitis

  • Prednisolone, azathioprine

Immunocomplex-associated disease
 Peripheral neuropathy

  • Intravenous gamma globulin

  • Rituximab

  • Plasma exchange

 Vasculitis

  • Prednisolone

  • Cyclophosphamide

  • Rituximab

  • Plasmapheresis

 Glomerulonephritis

  • Prednisolone, intravenous cyclophosphamide

 Central nervous system disease

  • Pulse steroids

  • Prednisolone

  • Cyclophosphamide

  • Azathioprine