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Sjögren's syndrome (SS), a chronic immune mediated disease associated with xerostomia and keratoconjunctivitis sicca, may occur alone (primary SS) or with other autoimmune diseases (secondary SS).1 The benefits of substitution treatment for dry eyes and mouth seem very variable. This survey assessed patients' experience of the wide variety of tear and saliva substitutes available.
Patients with SS, from Cannock Chase Hospital, University Hospital Birmingham, City Hospital Birmingham, or Birmingham Heartlands and Solihull Hospitals, completed a questionnaire, returned at their clinic visit or by prepaid post. SS was defined by the presence of four from six EC diagnostic criteria, with the modification that patients with primary SS must have anti-Ro antibodies (by enzyme linked immunosorbent assay (ELISA) or countercurrent immunoelectrophoresis) and/or have had a lip biopsy demonstrating features typical of SS.2 The questionnaire asked patients to identify, from a comprehensive list, all tear and saliva substitutes that they had ever heard of, had ever used, or were currently using, to identify useful source(s) of information about substitute treatment, and to rate the effectiveness of any treatments they had ever …