According to Dr. Steven Carson, of all the autoimmune disorders that are both chronic and joint-related, Sjogren’s syndrome remains the hardest to manage.
Standards of care designed to guide doctors to tested best practices will help improve consistency and quality of care. Such guidelines can also aid in reducing the burden of having Sjogren’s. In addition, it can be a standard for reimbursement policies.
Dr. Carson and his colleagues performed literature reviews. Next, they extracted data in order to develop their recommendations. Then their recommendations were reviewed by as many as 40 of his fellow clinicians involved in community practices and academia. Nurses, in addition to patients, weighed in on the recommendations. In total there are 13 strong-to-moderate recommendations.
- Self-care education should include exercise to decrease fatigue.
- Dehydroepiandrosterone, etanercept, nor infliximab medicines are not to be used for fatigue associated with Sjogren’s.
- Hydroxychloroquine (HCQ) should be considered as the first treatment for those with inflammatory musculoskeletal pain.
- If HCQ is not an effective treatment, then methotrexate should be considered next.
- Then if either drug does not work well alone, a combination therapy with HCQ and methotrexate can be used.
- If all of the above are ineffective then a corticosteroid can be used on a short-term basis.