Comparative efficacy and safety of topical therapies for ocular involvement in Sjögren's syndrome: a systematic review and network meta-analysis.

What was studied

This network meta-analysis compared eye drops for dry eye in Sjögren's syndrome. Searches ran up to April 29, 2026. Only randomized trials were used. Reviewers worked on their own to screen studies. They also rated the risk of bias. Treatments were ranked using SUCRA. Outcomes covered eye staining, tear time, tear flow and symptom scores.

What they found

Platelet-rich plasma drops did better than control on the eye staining score. Autologous serum also did well. For tear break-up time, serum and plasma drops both helped. Cyclosporine A improved tear flow on the Schirmer test. Cyclosporine A with diquafosol improved the symptom index. Tacrolimus had more adverse events than control.

What it means for patients

The authors say each therapy had gains for set outcomes. Plasma, serum and cyclosporine A may help surface damage, tear stability and tear flow. They say the findings need to be read with care.

Why it is not certain yet

Certainty of evidence was low to moderate. The networks were sparse. Direct comparisons were limited. Ranking was uncertain. Local inconsistency was found. Safety reporting was incomplete. These limits call for cautious reading.

Source

Comparative efficacy and safety of topical therapies for ocular involvement in Sjögren's syndrome: a systematic review and network meta-analysis.

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