effects of immune suppressant medications on dry mouth and eyes

[keelton]

i was just wondering if any of you that are taking systemic medications for sjogrens or mutiple autoimmune diseases, such as plaquinil, methotrexate, cellcept etc....  Have you noticed a decrease in dry eyes or mouth?  it seems like these medications help all other autoimmune diseases, as far as reducing the symptoms whether it is skin problems , pain, etc... but it seems to have no affect on dryness.   Why is this, when it is supposed to be suppressing the immune system from attacking itself???

I am hoping that some people get some benefit of reduced dryness from this??  but i never hear about it??

[Jasper]

I noticed a decrease in dryness after starting Plaquenil and CoQ10. I started taking both of them about the same time, fall of 2013. I don't know if Plaquenil is helping, but I feel CoQ10 is helping with the dryness. Studies show that over 80% of people who take CoQ10 (Ubiquinol form) have increased saliva. Mine gradually increased over the months.

I also receive Rituximab infusions every 24 weeks (starting last February). I feel that Rituximab has increased my saliva even further. I never carry water with me anymore or have to drink water at night. I can go for hours without drinking or sipping now. I drink nothing after 7 pm at night except a tiny sip of water when I go to bed about 10 pm.  I really don't get a dry mouth anymore. I always have saliva in my mouth. Of course, I doubt it is totally normal as pills occasionally get struck in my esophagus, but it is certainly noticeably improved.

The Rituximab studies had variable results when it came to saliva production increase. I recall one or more of the studies noting that the problem may be that the various study participants probably had differing degrees of residual salivary gland function left. Those with little gland function left, would have had little or no response and those with less damage would have had more response. The studies made no conclusions about the reason why some people respond and others do not. There may be other factors as well that affect the saliva production, especially since most people do have a fair amount of salivary gland function left even if they have very dry mouths. 

I use Restasis for my eyes and I do need it even though I am on Plaquenil and Rituximab. If I forget to put it in, I will get eye grittiness by the afternoon. However, my eye doctor did tell me last week that my eyes look the best since he has been seeing me. So, something is working well.

Not all of the drugs have the same effect. Many of the drugs that have been developed or that are in development have specific targets. For instance, Rituximab targets B cells, which we have too many of.  Some drugs that help one AI do not help other AIs. Even among the drugs that help the various symptoms of Sjogren's, they do not all help all symptoms. In addition, people react differently to the drugs. They may help one person but not another.

[Deb 27]

I noticed a slight difference when plaquenil got in my system. It also helped my joint pain  mostly. It does seem like it should help the dryness, I agree, but I don't think it works well for dryness. See what others say. It might take a stronger medication. I dunno, sometimes I think they under medicate us.

[Carebear]

I use both Plaquenil and Methotrexate, and unfortunately have not experienced any improvement in dryness in mouth or eyes as a result.  The only thing I have found helpful is to attack the dryness directly.  Sorry.

But as we know, we are all very individual with our results. 

[Kathy57]

Plaquinil has helped me with pain and fatigue but not the dryness.  Evoxac has helped me with dryness and I have obtained some more relief with Ubiquinol.

My mouth and eyes do feel much better than they did.  I think it's going to be a battle to the end.

Kathy

[cccourt1942]

As I understand Plaquenil, it is to slow progression of the disease itself.  In my case, my lacrimals and 5 of the major salivary glands have atrophied.  I was dxed at an advanced age.  The damage was done before my dx.  I take it anyway.  I do understand the efficacy of the drug for me is questionable.  I get relief from pilocarpine and Restasis.

Good luck
Sjoldier c3

[Scottietottie]

Hi 

Plaquenil is not an imunosuppressant. The other meds mentioned are.

Take care - Scottie