PMID- 33815105
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210406
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 12
DP  - 2021
TI  - Effectiveness and Safety of Iguratimod in Treating Primary Sjogren's Syndrome: A 
      Systematic Review and Meta-Analysis.
PG  - 621208
LID - 10.3389/fphar.2021.621208 [doi]
LID - 621208
AB  - Objectives: We aimed to assess the effectiveness and safety of iguratimod (IGU) 
      in treating primary Sjogren's syndrome (pSS) by meta-analysis. Methods: Eight 
      databases and two clinical trial websites were searched from conception to August 
      10, 2020, for relevant randomized controlled trials (RCTs) on outcomes of 
      patients with pSS treated with IGU. Revman 5.4 was used for statistical analysis 
      and creating plots. Results: A total of 1,384 patients with pSS from 19 RCTs were 
      included in this meta-analysis. Pooled results demonstrated that patients treated 
      with IGU + hydroxychloroquine (HCQ) + glucocorticoid (GC) showed significant 
      differences in erythrocyte sedimentation rate (ESR), rheumatoid factor (RF) 
      level, platelet (PLT) count, immunoglobulin G (IgG) level, salivary flow rate, 
      Schirmer's test result, EULAR Sjogren's Syndrome Patient Reported Index (ESSPRI), 
      EULAR Sjogren's Syndrome Disease Activity Index (ESSDAI), and efficacy rate (p </= 
      0.01) compared to patients treated with HCQ + GC. Compared to treatment with HCQ 
      and GC, co-administration of IGU with GC showed significant differences in ESR 
      and RF level (p </= 0.01); however, no significant differences were noted in IgG 
      level. Conversely, the IgG level showed a significant improvement in the IGU + 
      HCQ + GC group compared to the HCQ + GC group. The results of safety analysis 
      revealed that seven trials showed no significant differences in adverse events 
      (AEs) between the IGU + HCQ + GC and HCQ + GC groups (p = 0.15). Although no 
      severe AEs were noted, gastrointestinal discomfort was the most common AE in the 
      IGU group. No significant differences in AEs were observed between the IGU + GC 
      and HCQ + GC groups. Conclusion: IGU improved the clinical symptoms of patients 
      with pSS, including inflammatory indicators (ESR, IgG, and RF levels), PLT count, 
      secretion function of the salivary and lacrimal glands (salivary flow rate and 
      Schirmer's test result), and disease indexes (ESSDAI and ESSPRI), when 
      co-administered with HCQ + GC therapy without increasing the risks of AEs. 
      Therefore, IGU can be considered as an effective and safe drug for clinical 
      therapy of pSS. Considering the limitations of the present trials, more 
      long-term, multicenter, and high-quality RCTs are required to assess the 
      effectiveness and safety of IGU for treating patients with pSS.
CI  - Copyright (c) 2021 Pu, Wang, Riaz, Zhang, Gao, Pan, Wu, Liang, Zhuang and Tang.
FAU - Pu, Jincheng
AU  - Pu J
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji University 
      School of Medicine, Shanghai, China.
FAU - Wang, Xuan
AU  - Wang X
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji University 
      School of Medicine, Shanghai, China.
FAU - Riaz, Farooq
AU  - Riaz F
AD  - Department of Biochemistry and Molecular Biology, School of Basic Medical 
      Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China.
FAU - Zhang, Tongyangzi
AU  - Zhang T
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji University 
      School of Medicine, Shanghai, China.
FAU - Gao, Ronglin
AU  - Gao R
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji University 
      School of Medicine, Shanghai, China.
FAU - Pan, Shengnan
AU  - Pan S
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji University 
      School of Medicine, Shanghai, China.
FAU - Wu, Zhenzhen
AU  - Wu Z
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji University 
      School of Medicine, Shanghai, China.
FAU - Liang, Yuanyuan
AU  - Liang Y
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji University 
      School of Medicine, Shanghai, China.
FAU - Zhuang, Shuqi
AU  - Zhuang S
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji University 
      School of Medicine, Shanghai, China.
FAU - Tang, Jianping
AU  - Tang J
AD  - Department of Rheumatology and Immunology, Tongji Hospital, Tongji University 
      School of Medicine, Shanghai, China.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210319
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC8017188
OTO - NOTNLM
OT  - effectiveness
OT  - iguratimod
OT  - meta-analysis
OT  - primary Sjogren's syndrome
OT  - safety
COIS- The authors declared that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/04/06 06:00
MHDA- 2021/04/06 06:01
PMCR- 2021/03/19
CRDT- 2021/04/05 05:56
PHST- 2020/10/25 00:00 [received]
PHST- 2021/01/28 00:00 [accepted]
PHST- 2021/04/05 05:56 [entrez]
PHST- 2021/04/06 06:00 [pubmed]
PHST- 2021/04/06 06:01 [medline]
PHST- 2021/03/19 00:00 [pmc-release]
AID - 621208 [pii]
AID - 10.3389/fphar.2021.621208 [doi]
PST - epublish
SO  - Front Pharmacol. 2021 Mar 19;12:621208. doi: 10.3389/fphar.2021.621208. 
      eCollection 2021.