Home›Allergy & Immunology› Platelet-rich plasma, autologous serum, and cyclosporine A show specific benefits in Sjögren's syndrome dry eye
Platelet-rich plasma, autologous serum, and cyclosporine A show specific benefits in Sjögren's syndrome dry eyeTopical Eye Treatments Show Different Benefits for Sjögren's Dry Eyes
Frontiers in MedicinePublished August 26, 2026DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Consider platelet-rich plasma or autologous serum for surface damage and cyclosporine A for tear secretion in Sjögren's dry eye.
This systematic review and network meta-analysis evaluated the efficacy and safety of various topical ocular therapies, including platelet-rich plasma, autologous serum, cyclosporine A, diquafosol sodium, and tacrolimus, for patients with Sjögren's syndrome-related dry eye disease.
The analysis reported that platelet-rich plasma (SMD -6.96; 95% CI -9.76, -4.16) and autologous serum showed favorable effects on ocular staining scores compared to controls. Additionally, both autologous serum (MD 3.90; 95% CI 2.24, 5.56) and platelet-rich plasma (MD 3.85; 95% CI 1.48, 6.22) showed improvements in tear break-up time. Cyclosporine A was associated with improved tear secretion (MD 5.29; 95% CI 3.80, 6.78), and the combination of cyclosporine A plus diquafosol sodium improved Ocular Surface Disease Index scores (MD -2.40; 95% CI -3.21, -1.59).
Several limitations were noted, including sparse networks, limited direct comparisons, local inconsistency, and incomplete safety reporting. These factors contribute to low to moderate certainty of evidence regarding treatment ranking. Clinically, these findings suggest that specific topical therapies may offer targeted benefits for ocular surface damage, tear film stability, and tear secretion in Sjögren's syndrome patients.
How this fits prior evidence
This network meta-analysis addresses a gap in the management of Sjögren's syndrome-related dry eye by evaluating multiple topical interventions. While previous evidence noted that tacrolimus significantly reduces urine protein compared to MMF, placebo, and intravenous cyclophosphamide, this study focuses on local ocular treatments. It also provides specific data on cyclosporine A for tear secretion, which differs from the systemic focus of prior coverage regarding tacrolimus for renal protection.
Researchers looked at several topical eye treatments to see how they help patients with dry eyes caused by Sjögren's syndrome. The study compared options like platelet-rich plasma, autologous serum, cyclosporine A, diquafosol sodium, and tacrolimus against standard controls.
The findings suggest that different treatments may help in different ways. For example, platelet-rich plasma and autologous serum showed positive results for surface damage and tear film stability. Cyclosporine A was linked to better tear secretion, while a combination of cyclosporine A and diquafosol sodium improved overall surface disease scores.
It is important to note that the evidence for these findings is currently limited by small sample sizes and fewer direct comparisons between the treatments. Additionally, tacrolimus was associated with a higher risk of side effects compared to other options. Because the data is not yet definitive, patients should talk to their eye doctor to decide which treatment fits their specific needs.
What this means for you:
Different topical eye treatments may offer specific benefits for Sjögren's dry eyes, but evidence remains limited.
Common questions
Which treatments are best for surface damage?
The study found that both platelet-rich plasma and autologous serum showed favorable effects on ocular staining scores compared to a control. These treatments may help address issues related to the outer surface of the eye in patients with Sjögren's syndrome.
Can these drops improve tear production?
Cyclosporine A was associated with improved tear secretion when compared to a control. This suggests it may specifically help with the amount of tears produced by the eye in patients with Sjögren's syndrome.
Are there any safety concerns with these treatments?
The study noted that tacrolimus was associated with a higher risk of adverse events compared to the control group. Because evidence is limited, you should discuss specific risks and side effects with your doctor.
ObjectiveTo compare the efficacy and safety of topical ocular therapies for Sjögren’s syndrome–related dry eye disease.MethodsPubMed, Embase, Web of Science, Cochrane Central, CNKI, Wanfang, VIP, and CBM were searched from inception to April 29, 2026. Randomized controlled trials of topical ocular therapies were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias using RoB 2.0. A frequentist network meta-analysis was conducted in Stata 17.0. Treatment ranking was estimated using SUCRA.ResultsTwelve RCTs were included. For ocular staining score, platelet-rich plasma eye drops showed a favorable effect compared with control (SMD –6.96 [95% CI –9.76, –4.16]), and autologous serum also demonstrated a favorable effect. For tear break-up time, autologous serum and platelet-rich plasma showed relatively favorable improvements compared with control (MD 3.90 [95% CI 2.24, 5.56] and MD 3.85 [95% CI 1.48, 6.22], respectively). For Schirmer test, cyclosporine A was associated with improved tear secretion compared with control (MD 5.29 [95% CI 3.80, 6.78]). For Ocular Surface Disease Index, cyclosporine A plus diquafosol sodium showed improvement compared with control (MD –2.40 [95% CI –3.21, –1.59]). Tacrolimus was associated with a higher risk of adverse events than control (OR 2.12 [95% CI 1.01, 4.42]). The certainty of evidence was generally low to moderate, and these findings should be interpreted cautiously because of sparse networks, limited direct comparisons, and uncertainty in treatment ranking.ConclusionTopical ocular therapies showed outcome-specific advantages. Platelet-rich plasma, autologous serum, and cyclosporine A may benefit ocular surface damage, tear film stability, and tear secretion, respectively. However, sparse networks, local inconsistency, and incomplete safety reporting warrant cautious interpretation.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420261379380.
