Antimalarials for Sjögren’s Disease

Antimalarial drugs were first made to treat malaria. But doctors learned they also calm an overactive immune system, so they are now used in autoimmune diseases like Sjögren’s.^1,2

In Sjögren’s, the main antimalarial used is hydroxychloroquine. This article explains how this drug class works, which drug is used, and what to expect.^1,2

How do antimalarials work?

In autoimmune disease, the immune system attacks healthy tissue. Antimalarials help by decreasing the activity of the immune system. In Sjögren’s, doctors use them to help with whole-body symptoms such as joint pain, rashes, and fatigue.^1-4

These drugs do not cure Sjögren’s. They aim to ease symptoms and quiet the inflammation that drives them.

Examples

The antimalarial most often used in Sjögren’s is:^1-4

• Hydroxychloroquine (Plaquenil®) – A drug first designed to treat malaria that is often used to help treat Sjögren’s whole-body symptoms. It is also approved by the US Food and Drug Administration (FDA) for lupus and rheumatoid arthritis – 2 diseases that can overlap with Sjögren’s.

Hydroxychloroquine is not FDA-approved specifically for Sjögren’s. It is used off-label, which means a doctor prescribes a drug approved for another condition when evidence suggests it helps.^3,4

What to expect

Antimalarials work slowly. If you take hydroxychloroquine for symptoms, it may take several weeks to months before they improve. The drug comes as a tablet and is taken by mouth with food or milk. Because the drug can affect the eyes over time, your doctor will likely arrange regular eye exams during treatment. Do not stop taking it without talking to your doctor, since stopping can let symptoms return.⁴

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking. With hydroxychloroquine, more common side effects can include:⁴

• Stomach upset – Nausea, diarrhea, stomach pain, or vomiting can occur.
• Headache – Some people get headaches.
• Loss of appetite – You may not feel like eating.
• Hair changes – Hair loss or color changes can happen.

A rare but serious concern is eye damage, which is why eye monitoring matters. Call your doctor about vision changes such as blurred vision, floaters, or flashes of light.⁴

These are not all the possible side effects of antimalarials. Talk to your doctor about what to expect when taking antimalarials. You also should call your doctor if you have any changes that concern you when taking antimalarials.

Other things to know

Before beginning treatment for Sjögren’s disease, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

Some treatments listed here are not approved by the FDA to treat Sjögren’s disease. They may be approved for other conditions. A doctor may prescribe them “off-label” when evidence suggests they help. Talk to your doctor about what is right for you.

Talk to your doctor

Antimalarials are 1 tool for whole-body Sjögren’s symptoms, and they work differently for each person. Talk with your doctor about whether hydroxychloroquine fits your situation and what monitoring you will need.