What are the SSF guidelines for the use of tumor necrosis factor–alpha (TNF-?) inhibitors in the treatment of Sjögren syndrome?

Updated: Mar 05, 2021
  • Author: Sriya K Ranatunga, MD, MPH; Chief Editor: Herbert S Diamond, MD  more...
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The guidelines advise against use of tumor necrosis factor–alpha (TNF-α) inhibitors to treat sicca symptoms in patients with primary Sjögren syndrome. If TNF-α inhibition therapy is used for rheumatoid arthritis or other related overlap conditions in patients with Sjögren syndrome, health care providers should consider and monitor for the following:

  • Lymphoma and other malignancies (risk for non-Hodgkin is elevated)
  • Serious infections, including tuberculosis
  • Invasive fungal infections
  • Hepatitis B reactivation
  • Hepatotoxicity
  • Heart failure
  • Cytopenias
  • Hypersensitivity
  • Serious infusion reactions
  • Demyelinating disease

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