Non-Cochrane · intervention · PM42719096
Comparative efficacy and safety of topical therapies for ocular involvement in Sjögren's syndrome: a systematic review and network meta-analysis.
Gao Ao, Xie Tianhua, Huang Wenrui, et al. · Frontiers in immunology · 2026 · PubMed · doi:10.3389/fimmu.2026.1899484
Findings
115 findings
| Population | ||||
|---|---|---|---|---|
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | MD 1.23 [0.30, 2.16] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | MD 5.29 [3.80, 6.78] Moderate Downgraded: risk of bias Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Platelet-rich plasma eye drops | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Ocular staining score Sensitivity analysis: control restricted to placebo or vehicle | SMD -6.96 [-9.60, -4.33] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Adverse events (any) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | OR 1.75 [0.75, 4.09] Low Downgraded: risk of bias, imprecision Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Platelet-rich plasma eye drops | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Adverse events Sensitivity analysis: control restricted to placebo or vehicle | OR 1.12 [0.00, 318.11] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Ocular staining score Longest follow-up reported in each trial · Not specified · Overall (versus control node) | SMD -2.72 [-3.63, -1.81] Moderate Downgraded: risk of bias Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Platelet-rich plasma eye drops | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Tear break-up time Sensitivity analysis: control restricted to placebo or vehicle | MD 2.62 [-0.26, 5.51] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical tacrolimus | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Adverse events (any) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | OR 2.12 [1.01, 4.42] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical tacrolimus | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | MD 3.66 [1.94, 5.37] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Autologous serum eye drops | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Tear break-up time Sensitivity analysis: control restricted to placebo or vehicle | MD 2.65 [0.48, 4.82] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical tacrolimus | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Ocular staining score Longest follow-up reported in each trial · Not specified · Overall (versus control node) | SMD -3.57 [-4.88, -2.26] Moderate Downgraded: risk of bias Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical tacrolimus | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | MD 1.68 [0.45, 2.91] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Autologous serum eye drops | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Ocular staining score Sensitivity analysis: control restricted to placebo or vehicle | SMD -6.79 [-9.07, -4.51] GRADE not reported Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Autologous serum eye drops | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Adverse events Sensitivity analysis: control restricted to placebo or vehicle | OR 1.00 [0.02, 55.25] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | MD 0.60 [-0.08, 1.28] Moderate Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Adverse events (any) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | OR 0.38 [0.05, 2.83] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · Sensitivity analysis: control node restricted to placebo or vehicle controls | MD 0.60 [-0.08, 1.28] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | MD 1.13 [0.18, 2.08] Low Downgraded: imprecision, inconsistency Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical tacrolimus | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Adverse events Sensitivity analysis: control restricted to placebo or vehicle | OR 4.84 [1.25, 18.75] GRADE not reported Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical tacrolimus | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Ocular staining score Sensitivity analysis: control restricted to placebo or vehicle | SMD -2.95 [-3.87, -2.02] GRADE not reported Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical tacrolimus | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Tear break-up time Sensitivity analysis: control restricted to placebo or vehicle | MD 2.61 [0.33, 4.88] GRADE not reported Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical tacrolimus | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Schirmer test Sensitivity analysis: control restricted to placebo or vehicle | MD 3.76 [1.86, 5.67] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Ocular staining score Longest follow-up reported in each trial · Not specified · Overall (versus control node) | SMD -2.15 [-3.49, -0.81] Moderate Downgraded: inconsistency Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical cyclosporine A | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Adverse events Sensitivity analysis: control restricted to placebo or vehicle | OR 3.01 [0.78, 11.59] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | MD 3.60 [2.43, 4.77] Moderate Downgraded: risk of bias Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Adverse events (any) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | OR 1.00 [0.02, 46.04] Low Downgraded: risk of bias, imprecision Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical cyclosporine A | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Tear break-up time Sensitivity analysis: control restricted to placebo or vehicle | MD 1.44 [0.11, 2.76] GRADE not reported Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical cyclosporine A | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Ocular Surface Disease Index | MD -1.78 [-2.41, -1.16] GRADE not reported Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical cyclosporine A | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Ocular staining score Sensitivity analysis: control restricted to placebo or vehicle | SMD -4.31 [-5.94, -2.68] GRADE not reported Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical cyclosporine A | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Schirmer test Sensitivity analysis: control restricted to placebo or vehicle | MD 5.36 [3.76, 6.96] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Ocular staining score Longest follow-up reported in each trial · Not specified · Overall (versus control node) | SMD -6.79 [-9.17, -4.42] Moderate Downgraded: risk of bias Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | MD 3.90 [2.24, 5.56] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · Sensitivity analysis: control node restricted to placebo or vehicle controls | MD 3.60 [2.43, 4.77] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Ocular staining score Longest follow-up reported in each trial · Not specified · Overall (versus control node) | SMD -6.96 [-9.76, -4.16] Moderate Downgraded: risk of bias Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | MD 3.85 [1.48, 6.22] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | MD 3.58 [1.33, 5.83] Low Downgraded: risk of bias, inconsistency Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical corticosteroid | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Tear break-up time Sensitivity analysis: control restricted to placebo or vehicle | MD 0.66 [-0.64, 1.97] GRADE not reported Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical corticosteroid | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Adverse events Sensitivity analysis: control restricted to placebo or vehicle | OR 0.43 [0.05, 3.61] GRADE not reported Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical corticosteroid | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Ocular Surface Disease Index | MD -1.06 [-1.48, -0.65] GRADE not reported Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical corticosteroid | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Ocular staining score Sensitivity analysis: control restricted to placebo or vehicle | SMD -2.29 [-3.57, -1.02] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · Sensitivity analysis: control node restricted to placebo or vehicle controls | MD 3.58 [1.33, 5.83] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Adverse events (any) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | OR 1.12 [0.00, 257.74] Low Downgraded: risk of bias, imprecision Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical cyclosporine A plus diquafosol sodium | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Ocular Surface Disease Index | MD -2.4 [-3.21, -1.59] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Lacripep eye drops | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Adverse events (any) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | OR 1.30 [0.48, 3.50] Low Downgraded: risk of bias, imprecision Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical cyclosporine A plus diquafosol sodium | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Adverse events Sensitivity analysis: control restricted to placebo or vehicle | OR 3.01 [0.05, 196.07] GRADE not reported Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical cyclosporine A plus diquafosol sodium | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Tear break-up time Sensitivity analysis: control restricted to placebo or vehicle | MD 2.51 [0.64, 4.39] GRADE not reported Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical diquafosol sodium | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Tear break-up time Sensitivity analysis: control restricted to placebo or vehicle | MD 0.80 [-0.80, 2.40] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical diquafosol sodium | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | MD 0.42 [-1.05, 1.89] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical diquafosol sodium | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Ocular Surface Disease Index | MD -1.68 [-2.48, -0.88] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A plus diquafosol sodium | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | MD 2.80 [1.32, 4.28] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Lacripep eye drops | Control (artificial tears, lubricant, vehicle, placebo, polyvinylpyrrolidone, sodium hyaluronate or background treatment) | Adverse events Sensitivity analysis: control restricted to placebo or vehicle | OR 1.33 [0.45, 3.90] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A plus diquafosol sodium | Control (artificial tears, lubricant eye drops, sodium hyaluronate, vehicle, placebo, PVP or background control) | Adverse events (any) Longest follow-up reported in each trial · Not specified · Overall (versus control node) | OR 1.75 [0.03, 93.77] Low Downgraded: risk of bias, imprecision Studies not reported |
| People with Sjögren’s syndrome-related dry eye disease | Topical cyclosporine A plus diquafosol sodium | Topical cyclosporine A | Ocular Surface Disease Index | MD -0.62 [-1.14, -0.1] GRADE not reported Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A plus diquafosol sodium | Topical cyclosporine A | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 1.57 [0.40, 2.74] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical tacrolimus | Topical cyclosporine A | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 0.45 [-0.57, 1.47] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical tacrolimus | Topical cyclosporine A | Ocular staining score Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | SMD -0.86 [-2.09, 0.38] Moderate Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical tacrolimus | Topical cyclosporine A | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -1.63 [-2.63, -0.63] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Topical cyclosporine A | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -4.69 [-6.33, -3.05] Moderate Downgraded: risk of bias Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Topical cyclosporine A | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -0.10 [-1.44, 1.23] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Topical cyclosporine A | Ocular staining score Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | SMD 0.57 [-0.72, 1.86] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Topical tacrolimus | Ocular staining score Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | SMD 1.42 [-0.28, 3.13] Moderate Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Topical tacrolimus | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -0.55 [-2.07, 0.96] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Topical tacrolimus | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -3.06 [-4.90, -1.21] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Topical cyclosporine A | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -1.69 [-3.58, 0.21] Moderate Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Topical cyclosporine A | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 2.67 [0.76, 4.58] Moderate Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Topical cyclosporine A | Ocular staining score Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | SMD -4.08 [-6.62, -1.53] Moderate Downgraded: risk of bias Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Topical tacrolimus | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 2.22 [0.18, 4.26] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Topical tacrolimus | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -0.06 [-2.13, 2.02] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Topical tacrolimus | Ocular staining score Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | SMD -3.22 [-5.93, -0.51] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Topical corticosteroids | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 2.77 [0.85, 4.69] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Topical corticosteroids | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 3.00 [1.64, 4.36] Moderate Downgraded: risk of bias Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Topical corticosteroids | Ocular staining score Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | SMD -4.64 [-7.37, -1.91] Moderate Downgraded: risk of bias Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Topical cyclosporine A | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -1.71 [-4.41, 0.99] Moderate Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Topical cyclosporine A | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 2.62 [0.06, 5.18] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Topical cyclosporine A | Ocular staining score Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | SMD -4.24 [-7.19, -1.30] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Topical tacrolimus | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -0.08 [-2.91, 2.75] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Topical tacrolimus | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 2.17 [-0.49, 4.82] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Topical tacrolimus | Ocular staining score Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | SMD -3.39 [-6.48, -0.30] Low Downgraded: risk of bias, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Topical corticosteroids | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 2.98 [0.63, 5.33] Low Downgraded: risk of bias, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Topical corticosteroids | Ocular staining score Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | SMD -4.81 [-7.92, -1.71] Moderate Downgraded: risk of bias Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Topical corticosteroids | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 2.72 [0.16, 5.29] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Autologous serum eye drops | Ocular staining score Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | SMD -0.17 [-1.65, 1.31] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Autologous serum eye drops | Schirmer test (mm) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -0.02 [-1.94, 1.90] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Autologous serum eye drops | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -0.05 [-1.75, 1.65] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical diquafosol sodium | Topical cyclosporine A | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -0.81 [-1.97, 0.35] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical diquafosol sodium | Topical tacrolimus | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -1.26 [-2.81, 0.28] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical diquafosol sodium | Topical corticosteroids | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -0.71 [-2.47, 1.06] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical diquafosol sodium | Autologous serum eye drops | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -3.48 [-5.71, -1.25] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical diquafosol sodium | Platelet-rich plasma eye drops | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -3.43 [-6.24, -0.62] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A plus diquafosol sodium | Topical tacrolimus | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 1.12 [-0.43, 2.67] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A plus diquafosol sodium | Topical corticosteroids | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 1.67 [-0.10, 3.44] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A plus diquafosol sodium | Autologous serum eye drops | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -1.10 [-3.34, 1.14] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A plus diquafosol sodium | Platelet-rich plasma eye drops | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD -1.05 [-3.86, 1.76] Low Downgraded: risk of bias, imprecision, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A plus diquafosol sodium | Topical diquafosol sodium | Tear break-up time (seconds) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | MD 2.38 [0.76, 4.00] Moderate Downgraded: risk of bias, inconsistency Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A | Topical tacrolimus | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 0.83 [0.49, 1.40] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A | Topical corticosteroids | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 4.64 [0.62, 34.85] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical tacrolimus | Topical corticosteroids | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 5.60 [0.74, 42.55] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A | Autologous serum eye drops | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 1.75 [0.03, 88.56] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical tacrolimus | Autologous serum eye drops | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 2.12 [0.04, 104.54] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Autologous serum eye drops | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 0.38 [0.00, 28.58] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A | Platelet-rich plasma eye drops | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 1.57 [0.01, 386.28] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical tacrolimus | Platelet-rich plasma eye drops | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 1.89 [0.01, 458.97] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Platelet-rich plasma eye drops | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 0.34 [0.00, 111.76] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Platelet-rich plasma eye drops | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 0.89 [0.02, 42.68] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A | Lacripep eye drops | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 1.35 [0.37, 4.96] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical tacrolimus | Lacripep eye drops | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 1.63 [0.47, 5.59] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Lacripep eye drops | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 0.29 [0.03, 2.74] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Lacripep eye drops | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 0.77 [0.01, 40.16] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Lacripep eye drops | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 0.86 [0.00, 216.77] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical cyclosporine A | Topical cyclosporine A plus diquafosol sodium | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 1.00 [0.02, 48.82] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical tacrolimus | Topical cyclosporine A plus diquafosol sodium | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 1.21 [0.02, 61.08] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Topical corticosteroids | Topical cyclosporine A plus diquafosol sodium | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 0.22 [0.00, 17.20] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Autologous serum eye drops | Topical cyclosporine A plus diquafosol sodium | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 0.57 [0.00, 142.74] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Platelet-rich plasma eye drops | Topical cyclosporine A plus diquafosol sodium | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 0.64 [0.00, 539.26] Low Downgraded: risk of bias, imprecision Studies not reported |
| Patients with Sjögren's syndrome-related dry eye disease | Lacripep eye drops | Topical cyclosporine A plus diquafosol sodium | Adverse events (any) Longest follow-up reported in each trial · Not specified · League table (pairwise network estimate) | OR 0.74 [0.01, 44.75] Low Downgraded: risk of bias, imprecision Studies not reported |
Included primary studies 14
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Chen 2021 matched by author and year (probable) | NR | 7 other reviews | not stated | not extracted yet |
| Kang 2023 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Yang 2022 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Aragona 2013 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Aragona 2013 Safety and efficacy of 0.1% clobetasone butyrate eyedrops in the treatment of dry eye in Sjögren syndrome. PMID:23225089 | 2013 | this review only | not stated | not extracted yet |
| Bachtalia 2025 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Bachtalia 2025 The Effect of Autologous Serum Tears 50% on the Ocular Surface of Patients With Severe Dry Eye Disease due to Sjogren Syndrome: A… PMID:39808128 | 2025 | this review only | not stated | not extracted yet |
| Kang 2023 Efficacy and safety of platelet-rich plasma and autologous-serum eye drops for dry eye in primary Sjögren's syndrome: a randomized trial. PMID:37935760 | 2023 | this review only | not stated | not extracted yet |
| Moawad 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Moawad 2021 Evaluation of the effect of topical tacrolimus 0.03% versus cyclosporine 0.05% in the treatment of dry eye secondary to Sjogren syndrome. PMID:33530719 | 2022 | this review only | not stated | not extracted yet |
| Moscovici 2015 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Moscovici 2015 Treatment of Sjögren's syndrome dry eye using 0.03% tacrolimus eye drop: Prospective double-blind randomized study. PMID:25956572 | 2015 | this review only | not stated | not extracted yet |
| Tauber 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Tauber 2023 Elucidating the power in empowerment and the participation in participatory action research: a story about research team and elementary… PMID:20232244 | 2010 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with primary or secondary Sjögren's syndrome-related dry eye disease | Patients with Sjögren's syndrome-related dry eye disease (12 RCTs) |
| Intervention | Topical ocular therapies: cyclosporine A, tacrolimus, topical corticosteroids, autologous serum, platelet-rich plasma and other topical ocular medications | Cyclosporine A, tacrolimus, topical corticosteroids, autologous serum, platelet-rich plasma, Lacripep, diquafosol sodium, cyclosporine A plus diquafosol |
| Comparison | Placebo, vehicle, blank control, artificial tears, sodium hyaluronate, standard care or other topical ocular medications (merged into one control node) | Control node (artificial tears, lubricants, sodium hyaluronate, vehicle, placebo, PVP, background control) |
| Outcomes | Ocular staining score, tear break-up time, Schirmer test, adverse events; secondary: Ocular Surface Disease Index | Ocular staining score (9 RCTs, n=421); tear break-up time (9 RCTs, n=520); Schirmer test (7 RCTs, n=390); adverse events (11 RCTs, n=697); OSDI (3 RCTs, n=254) |
| Study designs | RCTs | 12 RCTs |
| Timing | Longest available follow-up per trial | Treatment duration 28 days to 6 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | No | no |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |