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Sjogren’s syndrome (SS) is a systemic autoimmune disease involving not only the exocrine glands, but also multiple systems such as kidney, lung or nervous system. Janus kinase (JAK) plays a key role in many signal pathways of cytokines involving the pathogenesis of SS, including type I interferon (IFN) pathway, interleukin (IL)-6, IL-17, IL-12 and IL-23.1 Baricitinib, a selective JAK1 and JAK2 inhibitor, has reliable therapeutic benefit in patients with rheumatoid arthritis (RA).2 There were also some clinical trials and case reports of baricitinib in other autoimmune diseases, including systemic lupus erythematosus (SLE),3 dermatomyositis, polymyalgia rheumatica and giant cell arteritis.1 So far, only one basic study demonstrated baricitinib suppressed IFN-γ-induced CXCL10 expression in human salivary gland ductal cells and suggested its potential for the treatment of SS.4 There is no clinical evidence of baricitinib in SS.
In this pilot study, we explored the efficacy and safety of baricitinib in active SS patients. We enrolled 11 patients (table 1) fulfilling the criteria of the 2016 American College of Rheumatology/European League Against Rheumatism (EULAR) classification for primary SS,5 with moderate or high disease activity, which was defined as EULAR primary SS Disease Activity Index (ESSDAI) ≥5.6 The ESSDAI, EULAR primary SS Patient Reported Index (ESSPRI), Physician Global Assessment (PGA) scores, serological activity including erythrocyte sedimentation rate (ESR) and IgG level and remission of organ manifestations were evaluated. Response to treatment, or minimal clinically …
Handling editor Josef S Smolen
Contributors WB, X-ML and YZ contributed to the conception and design of the study; WB, HL, LD, Y-JY and X-ML contributed to patient recruitment and follow-up; WB performed the literature review, literature screen, data collection and analysis; X-ML, ML, WZ, YZ and XZ helped data analysis and evaluation; WB drafted the manuscript; X-ML, YZ and XZ supervised the study and revised the manuscript.
Funding This study was supported by the Chinese National Key Technology R&D Programme, Ministry of Science and Technology (2017YFC0907601, 2017YFC0907605), CAMS Innovation Fund for Medical Sciences (CIFMS) (2019-I2M-2–008).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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