Hope for 2016 – 5 upcoming treatments for Sjogren’s Syndrome

Happy new year everyone!

Holiday and new years celebrations tend to evoke a lot of memories for me, particularly of healthier times before SS symptoms. In an effort to focus on the positive, I decided to look over promising treatment research over the past year. 2015 brought with it news of medical advances, giving hope to those of us who suffer from Sjogren’s Syndrome. I have compiled a list of my 5 most promising advances in medical research in 2015 which provide hope for new treatments in 2016 and beyond.

5. BCG Vaccine

I noted in an earlier post that Dr. Denise Faustman had raised around $20 million and kicked off a phase 2 trial using the BCG vaccine to treat diabetes. This also had promising implications for SS, as Dr. Faustman has done SS research in the past and has indicated that the vaccine could be a potential SS treatment. The trial is also one of the first large-scale trials that I am aware of which was largely crowd-sourced and outside the control of large pharmaceutical companies. Hopefully we will see more research in the same vein.

Unfortunately, trials for diabetes will take many years, so we SS sufferers shouldn’t expect results very soon.

4. Old drugs are being trialed for Sjogren’s Syndrome

Over the past decade, there has been an explosion of biologic drugs to treat various autoimmune conditions. Humira, Enbrel, Rituxan, and Benlysta are all brand name biologics that treat a variety of conditions, including rheumatoid arthritis, Crohn’s Disease, and even Lupus.

Unfortunately, Sjogren’s Syndrome has missed out on the bonanza. There has never been a single systematic treatment approved by the FDA for SS (even Plaquenil is off-label). There are signs that the tide is changing, however. Active clinical trials for biologics Rituxan and BenlystaOrencia, and Actemra, as well as non-biologics like Recombinant Human IL-2 bring hope that new treatments are around the corner, particularly for drugs that have already been shown to be effective on autoimmune disorders. Orencia has an active phase 3 trial, and a Benlysta phase 2 trial was successfully completed, so these treatments may be only a couple years away. Even a successful phase 2 trial can open these approved drugs for off-label use with SS.

3. New drugs are being trialed for Sjogren’s Syndrome

Perhaps even more exciting, clinical trials for new biologic drugs are being conducted with SS patients before they have been approved for other disorders. This illustrates a renewed interest in combating SS, and a use of drugs that were designed specifically to combat SS (and hopefully will have a better success rate). These experimental drugs include:

While these are all in phase 1 and 2 trials, success will hopefully lead to better, more targeted treatments for Sjogren’s Syndrome. I would also note that UCB5857 is a small molecule inhibitor, rather than a biologic drug, and would likely have fewer side effects if testing is successful.

2. Peptides

I haven’t written a post about it, but one of the most exciting treatments I have followed over the past few years are small peptides. These small proteins stimulate T-regulatory cells so that a patient’s body corrects itself. The treatment should have far fewer side effects that typical biologic drugs. Northwestern carried out a successful study on peptides in lupus in 2013, and another lupus drug, Lupuzor has just entered phase 3 clinical trials in December. While phase 2 trials were a bit hit or miss, there are signs that the better designed phase 3 trial may show success when it concludes in 2017. We are potentially 2 years away from a treatment that could  put lupus into remission with minimal side effects, and its developers aren’t stopping at lupus. To quote last month’s article:

“According to preclinical findings, LupuzorTM may also be effective in other chronic autoimmune pathologies, such as Sjögren’s syndrome (dry eye syndrome) or Crohn’s disease (an autoimmune disease that causes chronic intestinal inflammation). Fundamental studies on these promising leads are now underway in Sylviane Muller’s laboratory.”

1. Stem cells

Ever since I read a 2012 study that showed remarkable improvement in SS patients treated with mesenchymal stem cells, I have considered it the treatment with greatest promise. Previous studies explored autologous stem cell transplants, where a patient’s immune system is destroyed by chemo therapy before being regenerated with stem cells. Such treatments were very risky, and only used in the worst cases. Current research into mesenchymal stem cells, however, takes and grows our own stem cells, then returns them to better regulate a patient’s existing immune system. This treatment is much safer than previous transplants.

Using our bodies’ own regulatory capabilities has always made sense to me, and stem cells have shown remarkable promise in a wide array of treatments. While research has been a bit quiet on the SS front, there have been promising studies around other autoimmune diseases, such as lupus and schleroderma, including animal studies published in summer 2015. With increasing money being directed to stem cell research, it seems that it shouldn’t be long before we see a viable treatment option for SS.

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