The last year, significant progress has been made in the diagnostics, evaluation and treatment of primary Sjögren’s syndrome (pSS). The progress in the various areas will be discussed in detail.
With regard to diagnostics, preliminary American College of Rheumatology classification criteria (ACR) were introduced in 2012. These criteria fully rely on objective tests and do not make a difference between pSS and secondary SS (sSS). The preliminary ACR criteria will be discussed in relation to the widely used American European Consensus Group (AECG) criteria. With regard to replacing or adding AECG classification criteria, the diagnostic power of salivary gland ultrasonography (SGUS) is promising. Besides being a potential asset for the diagnostic work-up, SGUS might also play a role in monitoring the patient over time.
How disease activity in pSS can be assessed has always been an issue, both for patient care and trials. The recently developed EULAR Sjögren’s syndrome disease activity index (ESSDAI) and EULAR Sjögren’s syndrome patient reported index (ESSPRI) will be discussed including their usefulness for evaluating the effect of biologicals in the treatment of pSS.
Recently, the results of a number of biological immunosuppressive drugs have become available. The results of these studies will be discussed in detail taking the effects that can be achieved with traditional treatment into account. The steps to improve early detection, assessments for disease activity and monitoring are important for the development of well designed intervention studies with these promising new drugs.
Finally, key advances reported during the last 12 months in understanding the pathogenesis of pSS will be discussed.
Acknowledgements with thanks to Prof. A. Vissink, Prof. F.K.L. Spijkervet, Prof. F.G.M. Kroese and members of the EULAR working group on Sjögren’s syndrome
Disclosure of Interest H. Bootsma Consultant for: Hoffmann-La Roche, Bristol Myers Squibb, UCB Biosciences Inc.
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