UPMC Rheumatology Launches Dedicated Center for Sjögren’s Disease Treatment and Research

During her recent rheumatology fellowship at UPMC, Rachael Gordon, MD, PhD, recognized the need for a multidisciplinary program to treat patients with Sjögren’s disease. On July 1, 2024, she became assistant professor in the UPMC Division of Rheumatology and Clinical Immunology and started the first center at UPMC to comprehensively care for patients with Sjögren’s disease and advance research for innovative therapies.

The autoimmune disease is nearly as common as rheumatoid arthritis. Yet, there aren’t any FDA-approved disease modifying therapies.

While characteristically, Sjögren’s affects the exocrine glands – the secreting glands like the tear- and saliva-producing glands – Dr. Gordon says it’s a systemic disease that could affect nearly any organ system, from the kidneys to the lungs, joints, skin, and nervous system.

“This isn’t just a disease of dry eyes and mouth,” says Dr. Gordon. “Thirty to fifty percent of patients will have involvement that goes well beyond the saliva- and tear-producing glands. These patients are suffering and I have few dedicated therapeutics to offer them; we borrow treatments from the other rheumatologic diseases that we treat. And so, that’s a major challenge for us.”

The Need for Multidisciplinary Care

According to Dr. Gordon, compared to other rheumatologic diseases, about 5 to 10% of patients with Sjögren’s disease will go on to develop lymphomas. For this reason, counseling patients, as well as screening them for malignancy is crucial.

“A major challenge in our fields up to this point is we really need multidisciplinary care amongst multiple subspecialties to care for this patient population,” adds Dr. Gordon. “We have a cohort of subspecialty experts, including dentists, ophthalmologists, neurologists, and oncologists who are fantastic partners. I'm able to refer out to them and help coordinate care using our team as a mechanism to that.”

Dr. Gordon also partners with the UPMC Vision Institute on an existing dry eye clinic at UPMC Mercy Pavilion. She sees patients monthly with ophthalmologist Vishal Jhanji, MD.

What Patients Can Expect at Their First Visit

Dr. Gordon sees patients weekly at the clinic located in the UPMC Arthritis and Autoimmunity Center in Oakland, Pittsburgh. When referred, the patient should have a Sjögren’s disease diagnosis. New patients will review a thorough history with Dr. Gordon detailing their symptoms.

“We do a very detailed history to understand what clinical manifestations of Sjögren’s the patient has. For instance, you don't want to miss that vasculitis rash on their legs that's covered up by their pants. That's a potential clue of a much more serious version of Sjögren’s disease that really needs significant immunosuppressive therapy,” she explains.

Dr. Gordon will perform a comprehensive physical exam. The center also offers dry eye testing and can measure saliva production. Each patient will undergo a salivary gland ultrasound.

She then counsels patients on the management of their dryness along with other manifestations of Sjögren’s that the patient may have.

“If the patient has clues that they might have other organs involved, we order appropriate diagnostic testing to address that. I do significant counseling about the risk of lymphoma,” adds Dr. Gordon.

Follow-up appointments can be made at the Oakland location or via telemedicine. In-person annual visits are recommended.

In addition to the comprehensive center, Dr. Gordon is building a research program where her team can learn and better understand this disease and conduct research that will fuel the development of future therapies.

To discuss a possible patient referral, consultation, or to learn more about the Sjögren’s disease center, call 412-647-6700.