Zielgerichtete Immuntherapien beim primären Sjögren-Syndrom

ZUSAMMENFASSUNG

Das primäre Sjögren-Syndrom ist eine komplexe und sehr heterogene Erkrankung, die mit einer chronischen Epitheliitis der exokrinen Drüsen einhergeht und somit zur Sicca-Symptomatik führt. In mehr als der Hälfte der Fälle kommt es jedoch auch zu extraglandulären Verläufen. Aktuelle EULAR-Therapieempfehlungen orientieren sich an klinischen Manifestationen und Wirkstoffen, die auch beim systemischen Lupus erythematodes genutzt werden. Empfehlungen für den Einsatz von Biologika-Therapien gibt es wenige: Rituximab bei schweren neurologischen und/oder vaskulitischen Manifestationen, Abatacept bei therapierefraktärer Arthritis und Belimumab bei therapierefraktärer Parotisschwellung. Doch viele neue Wirkansätze werden aktuell in Studien verfolgt. Insbesondere die Daten zu Ianalumab, Iscalimab und Dazodalibep sind vielversprechend. Weitere ganz neue Wirkprinzipien in der rheumatologischen Therapie, wie der Proteasomen-Inhibitor Bortezomib, niedrig dosiertes I2, Pl3Kδ-Inhibitoren oder der Einsatz von mesenchymalen Stammzellen sind ebenfalls Gegenstand aktueller Studien.

Schlüsselwörter

Sjögren-Syndrom - Biologika-Therapien - CD40-Inhibitoren - BAFF-R-Inhibitoren - Zytokin-Inhibitoren

• Literatur

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