Targeted Therapy for Primary Sjögren's Syndrome: Where are We Now?

Area of Science:

• Immunology
• Rheumatology
• Pharmacology

Background:

• Primary Sjögren's syndrome (pSS) is an autoimmune disease causing dryness.
• Current treatments for pSS are limited, necessitating novel therapeutic approaches.

Purpose of the Study:

• To review recent advancements in targeted therapies for primary Sjögren's syndrome.
• To evaluate the efficacy and challenges of current targeted treatments for pSS.

Main Methods:

• Review of clinical trials and scientific literature on targeted therapies for pSS.
• Analysis of biologics (e.g., B cell-depleting agents, cytokine inhibitors) and small molecule inhibitors.
• Examination of outcome measures like the European League Against Rheumatism Sjögren's Syndrome Disease Activity Index (ESSDAI).

Main Results:

• Evidence for the efficacy of targeted therapies in pSS remains sparse.
• Several biologics, including ianalumab and iscalimab, show promise but require larger trials.
• Many evaluated biologics demonstrated no significant difference compared to placebo in clinical trials.

Conclusions:

• The efficacy of current targeted therapies for pSS is limited by disease heterogeneity and irreversible glandular damage.
• Future strategies should focus on early diagnosis and glandular function-centered outcome measures.
• Improved clinical trial design and patient selection are crucial for advancing pSS systemic therapy.