متلازمة شوغرن مع التهاب المفاصل النشط: بروتوكول الخط التالي عند فشل الكورتيكوستيرويدات في تحقيق استجابة ESSDAI

Arthritis is clinically diagnosed on the basis of objective inflammation of ≥1 joints (heat, redness and swelling in the physical examination of the affected joint) supported by ultrasound studies when in doubt, and the ESSDAI score classifies the severity of arthritis according to the number of joints involved (moderate <5 joints, high >5).

The lack of head-to-head studies comparing the efficacy and safety profile of immunosuppressive agents in primary SjS-2002 (leflunomide, methotrexate, azathioprine, mycophenolate, cyclophosphamide) does not permit a recommendation on the use of one agent over another, except when patient characteristics or comorbidities are considered with respect to the safety profile.

With respect to the definition of the therapeutic response in systemic SjS, the TF recommends using a reduction of ≥3 points in the global ESSDAI score.