Current and future therapies for primary Sjögren syndrome

Area of Science:

• Rheumatology
• Immunology
• Systemic Autoimmune Diseases

Background:

• Primary Sjögren syndrome (pSS) is a systemic autoimmune disease characterized by dryness, pain, and fatigue, affecting one-third to one-half of patients with systemic involvement.
• Current management of pSS is hindered by a lack of effective treatments, with therapeutic decisions often based on clinical experience rather than robust evidence.

Purpose of the Study:

• To review the current evidence for systemic treatments in primary Sjögren syndrome (pSS).
• To discuss advances in outcome assessment, disease activity scoring, and patient-reported outcomes for pSS.
• To provide an overview of promising future therapeutics for pSS.

Main Methods:

• Systematic review of available evidence for systemic treatments in pSS.
• Discussion of advances in classification criteria, systemic disease activity scoring, and patient-reported outcomes.
• Analysis of current evidence for disease-modifying antirheumatic drug (DMARD) use in pSS.

Main Results:

• Significant progress has been made in understanding pSS epidemiology and pathogenesis, leading to more targeted therapeutic approaches.
• The 2019 European Alliance of Associations for Rheumatology (EULAR) management recommendations are increasingly informing clinical practice for pSS.
• Advances in outcome assessment and patient-reported outcomes are improving the evaluation of treatment efficacy in pSS.

Conclusions:

• Despite challenges, advances in understanding pSS pathogenesis and improved outcome measures are paving the way for more effective, evidence-based treatments.
• The review highlights the need for continued research into novel therapeutics to address the unmet needs in pSS management.
• Future therapeutic strategies for pSS are expected to be more targeted, informed by a deeper understanding of the disease mechanisms.