Trial reportRheumatology international2021
Revisiting the JOQUER trial: stratification of primary Sjögren's syndrome and the clinical and interferon response to hydroxychloroquine.
Trial report in Rheumatology international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- British Society for Rheumatology guideline on management of adult and juvenile onset Sjögren disease.Rheumatology (Oxford, England) · 2025Guideline
- Pooled it
- Clinical and Ultrasonographic Characterization of Proposed Sjögren's Disease Phenotypes in a Korean Longitudinal Cohort.Journal of clinical medicine · 2026Article
- Construction of a nomogram for anxiety and depression in patients with Sjögren's syndrome by combining tongue and pulse characteristics: a cross-sectional study based on a prospective cohort.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2026Article
- Molecular classification of primary Sjögren's syndrome based on salivary gland omics.Arthritis research & therapy · 2026Article
- Low-to-moderate dose glucocorticoids in primary Sjögren's syndrome patients on hydroxychloroquine/iguratimod therapy: a target trial emulation study.Clinical rheumatology · 2026Article
- From immune activation to symptom burden: mechanisms and translational implications of immune-symptom uncoupling in Sjögren's disease.Frontiers in immunology · 2026Review
- Investigating the role of tripartite motif containing-21 and interleukin-6 in pro-Inflammatory symptom-associated heterogeneity within primary Sjögren's syndrome.Rheumatology and immunology research · 2025Article
- Stability of symptom-based subtypes in Sjogren's disease.RMD open · 2024Article
- Amplified Type I Interferon Response in Sjögren's Disease via Ectopic Toll-Like Receptor 7 Expression in Salivary Gland Epithelial Cells Induced by Lysosome-Associated Membrane Protein 3.Arthritis & rheumatology (Hoboken, N.J.) · 2024Article
- Assessment of hydroxychloroquine blood levels in Sjögren's disease patients: drug adherence and clinical associations.Rheumatology international · 2024Observational
- Long Non-Coding RNAs in Sjögren's Disease.International journal of molecular sciences · 2024Review
- Identification of distinct subgroups of Sjögren's disease by cluster analysis based on clinical and biological manifestations: data from the cross-sectional Paris-Saclay and the prospective ASSESS cohorts.The Lancet. Rheumatology · 2024Article
- What can patients tell us in Sjögren's syndrome?Rheumatology and immunology research · 2024Review
- Manifestations and management of Sjögren's disease.Arthritis research & therapy · 2024Review
- An Early View of Iran Primary Sjogren Syndrome Registry (Guilan Province Pilot Phase), an Emerging Effort for a National Registry Establishment.Medical journal of the Islamic Republic of Iran · 2024Article
- The Spectrum of Extraglandular Manifestations in Primary Sjögren's Syndrome.Journal of personalized medicine · 2023Review
- Salivary gland LAMP3 mRNA expression is a possible predictive marker in the response to hydroxychloroquine in Sjögren's disease.PloS one · 2023Article
- Symptom-Based Cluster Analysis Categorizes Sjögren's Disease Subtypes: An International Cohort Study Highlighting Disease Severity and Treatment Discordance.Arthritis & rheumatology (Hoboken, N.J.) · 2022Article
- The stratification of primary Sjogren's syndrome: is it really solving the problem?Rheumatology international · 2021Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
To re-analyse the clinical outcomes and interferon (IFN) activity data from the JOQUER trial, a phase III trial investigating hydroxychloroquine (HCQ) in patients with primary Sjögren's syndrome (pSS), after stratifying patients into putative pathobiological subgroups utilizing the Newcastle Sjögren's Stratification Tool (NSST) based on patient-reported symptoms of dryness, pain, fatigue, anxiety and depression. 107 patients were assigned to one of four subgroups using NSST at baseline-the high symptom burden (HSB), pain dominant with fatigue (PDF), dryness dominant with fatigue (DDF) and low symptom burden (LSB). Endpoints were re-analysed after stratification, testing for treatment differences within subgroups and adjusting for baseline differences using a repeated measures covariate model. The HSB subgroup (n = 32) showed a relative improvement in ESSPRI of 1.49 points (95% CI 0.54-2.43; p = 0.002) within 12 weeks in patients taking HCQ compared to placebo, with no further changes after 24 weeks. For the LSB subgroup (n = 14), the ESSPRI worsened in the placebo but not the HCQ arm after 12 weeks (mean difference 1.44, 95% CI 0.05-2.83, p = 0.042). Neither the HSB nor the LSB patients showed significant changes in IFN activity at 24 weeks. There were no significant differences in ESSPRI in the PDF (n = 39) and DDF (n = 22) patients taking HCQ. However, significant reductions in overall IFN score at 24 weeks were seen in both PDF (difference at 24 weeks; 6.41, 95% CI, 2.48-10.34, p = 0.002) and DDF (difference at 24 weeks; 7.23, 95% CI, 1.85-12.6, p = 0.009) without improvement in ESSPRI. Although the JOQUER trial reported no overall benefit from HCQ in pSS patients, stratification suggests that both HSB and LSB subgroups may respond to HCQ. However, these patients may benefit through mechanisms other than the reduction of IFN activities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.