What are the Sjögren’s Syndrome Foundation (SSF) treatment guidelines for inflammatory musculoskeletal pain in Sjögren syndrome?

Updated: Mar 05, 2021
  • Author: Sriya K Ranatunga, MD, MPH; Chief Editor: Herbert S Diamond, MD  more...
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The following recommendations are listed in order of preference for use in the treatment of inflammatory musculoskeletal pain in primary Sjögren syndrome; if a therapy is insufficiently effective, the physician is advised to try the next recommendation in sequence, and so on:

  1. Hydroxychloroquine; first-line treatment
  2. Methotrexate
  3. Hydroxychloroquine plus methotrexate
  4. Short-term (1 month or less) corticosteroids (15 mg or less a day); long-term corticosteroids (≤15 mg/d for more than 1 month) may be useful, but efforts should be made to find a steroid-sparing agent as soon as possible
  5. Leflunomide
  6. Sulfasalazine
  7. Azathioprine (may be a better choice than leflunomide or sulfasalazine in patients with major organ involvement)
  8. Cyclosporine

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