Sjogren’s syndrome – Treatment

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Living with Sjögren’s syndrome means learning how to manage persistent dryness throughout your body, but with the right combination of treatments and daily care strategies, many people continue to lead active, fulfilling lives despite this challenging autoimmune condition.

Finding Relief Through Modern Treatment Options

When someone receives a diagnosis of Sjögren’s syndrome, the first question that often comes to mind is: what can be done to feel better? The treatment journey for this condition is deeply personal, as each patient experiences different symptoms with varying levels of severity. The main goal of treatment is not to cure the disease—because currently no cure exists—but rather to help manage symptoms, prevent complications, and improve quality of life. This means working closely with healthcare providers to find a tailored plan that addresses your specific challenges, whether that’s extreme dryness, fatigue, joint pain, or organ involvement.[1]

Treatment approaches for Sjögren’s syndrome depend heavily on which parts of your body are affected and how severe your symptoms are. Some people experience only mild discomfort and can manage with over-the-counter products and lifestyle adjustments. Others face debilitating symptoms that greatly impair their daily functioning and require prescription medications or more intensive interventions. Because Sjögren’s is a systemic disease that can affect the entire body, your healthcare team may include several specialists—a rheumatologist to coordinate overall care, an ophthalmologist for eye concerns, a dentist for oral health, and possibly others depending on which organs are involved.[2]

The good news is that medical societies have developed standard treatment recommendations based on years of research, and at the same time, scientists continue to explore new therapies through clinical trials. This means that patients today have access to proven treatments while researchers work on developing even better options for the future.[4]

Standard Approaches to Managing Sjögren’s Symptoms

The foundation of treating Sjögren’s syndrome starts with addressing the most common and bothersome symptom: dryness. For dry eyes, many patients begin with artificial tears—lubricating eye drops that can be purchased without a prescription. These drops temporarily replace natural tears and should be used throughout the day to prevent discomfort and protect the surface of the eye. It’s important to choose preservative-free formulations, especially if you need to use drops frequently, because preservatives can irritate already sensitive eyes.[6]

When over-the-counter artificial tears aren’t enough, doctors may prescribe special eye drops that do more than just add moisture—they actually help your eyes produce more natural tears. Two medications commonly prescribed for this purpose are cyclosporine (brand name Restasis) and lifitegrast (brand name Xiidra). These prescription eye drops work by reducing inflammation on the surface of the eye, which allows the tear glands to function better. Patients typically need to use these drops twice daily, and it may take several weeks before you notice improvement. Some people experience a burning sensation when first using cyclosporine drops, but this side effect often lessens over time.[4]

For dry mouth, the treatment strategy is similar—starting simple and advancing to prescription medications if needed. Sipping water throughout the day, chewing sugar-free gum, and sucking on sugar-free hard candies can all help stimulate saliva production. However, when these measures aren’t sufficient, doctors may prescribe medications that directly stimulate the salivary glands. The two main drugs used for this purpose are pilocarpine (brand name Salagen) and cevimeline (brand name Evoxac). These medications cause the salivary glands to produce more saliva by acting on certain receptors in the glands. Common side effects can include sweating, flushing, and increased need to urinate, because these drugs affect similar receptors throughout the body.[9]

⚠️ Important
Chronic dry mouth significantly increases your risk of tooth decay and gum disease because saliva normally helps wash away bacteria and neutralize acids in the mouth. People with Sjögren’s syndrome should see their dentist every six months and practice excellent oral hygiene by brushing with fluoride toothpaste at least twice daily and flossing regularly. This preventive care is not optional—it’s essential for protecting your teeth and preventing painful infections.[6]

Joint pain and muscle aches are common in Sjögren’s syndrome, affecting many patients beyond the signature dryness symptoms. For these concerns, doctors often recommend nonsteroidal anti-inflammatory drugs or NSAIDs. These medications reduce inflammation and pain by blocking the production of prostaglandins—chemicals in the body that promote inflammation and cause pain. Common over-the-counter NSAIDs include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). Many prescription-strength NSAIDs are also available. The most common side effect is stomach upset, and in rare cases, NSAIDs can cause stomach bleeding. Taking these medications with food or milk can help reduce stomach irritation.[9]

When Sjögren’s syndrome causes more serious systemic problems—affecting internal organs like the lungs, kidneys, or nervous system, or when joint pain and fatigue become severe—stronger medications may be necessary. Hydroxychloroquine is a medication originally developed to treat malaria but now commonly used for autoimmune conditions. It helps reduce inflammation throughout the body and may help with fatigue and joint pain. This medication must be taken daily for several months before its full benefits are seen.[4]

For more severe cases, doctors may prescribe medications that more powerfully suppress the immune system. These include corticosteroids (such as prednisone), which quickly reduce inflammation but can have significant side effects if used long-term, including weight gain, increased blood sugar, bone thinning, and increased infection risk. Other immune-suppressing medications used in Sjögren’s include methotrexate (Rheumatrex), azathioprine (Imuran), and mycophenolate (Cellcept). These medications are typically reserved for patients with serious organ involvement or symptoms that haven’t responded to other treatments.[4]

In life-threatening cases or when major organs are severely affected, a medication called rituximab (Rituxan) may be used. This drug works by targeting and temporarily depleting certain white blood cells called B-lymphocytes, which play a role in the autoimmune attack. Rituximab is given as an intravenous infusion, meaning it’s delivered directly into a vein over several hours in a medical facility. For patients with nervous system involvement, intravenous immunoglobulin therapy (IVIG) might provide benefits. This treatment involves infusing antibodies collected from donated blood plasma to help modulate the immune system.[4]

Patients who experience acid reflux—a common problem when you have dry mouth and reduced saliva—may benefit from medications called proton-pump inhibitors or H2 blockers. These medications reduce the amount of acid your stomach produces, helping prevent damage to the esophagus and reducing that unpleasant burning sensation.[4]

Standard treatment typically continues for years, often for a patient’s entire life. The duration and intensity of treatment depend on how active the disease is and which symptoms are most troublesome. Regular monitoring by healthcare providers is essential to assess whether treatments are working, to watch for side effects, and to adjust the treatment plan as needed over time.[2]

Promising New Therapies Being Tested in Clinical Trials

While standard treatments help many people with Sjögren’s syndrome manage their symptoms, researchers recognize that current options don’t work for everyone and that better therapies are needed. This has led to growing interest from pharmaceutical companies and research institutions in developing new treatments specifically for this condition. Clinical trials are research studies that test new drugs or therapies to determine whether they are safe and effective. These trials represent hope for patients who haven’t found adequate relief with existing treatments.[10]

Clinical trials typically progress through several phases. Phase I trials focus primarily on safety—researchers want to know if the new treatment causes harmful side effects and what dose is appropriate. These studies usually involve small numbers of participants. Phase II trials expand to larger groups and focus on whether the treatment actually works—does it improve symptoms or slow disease progression? Phase III trials compare the new treatment directly against current standard treatments to see if the new option is better, equally effective, or perhaps causes fewer side effects. Only after successfully completing these phases can a new drug be approved by regulatory agencies like the FDA in the United States or similar bodies in other countries.[10]

Several innovative therapies are currently being evaluated in Phase II and Phase III clinical trials for Sjögren’s syndrome. One promising drug is called dazodalibep. This medication works by targeting a specific molecular pathway that drives inflammation in autoimmune diseases. Dazodalibep blocks the interaction between two proteins—CD40 and CD40 ligand—that normally work together to activate immune cells. By interrupting this communication, the drug aims to reduce the immune system’s attack on moisture-producing glands. Early trial results have shown that patients taking dazodalibep experienced improvements in clinical parameters measuring disease activity, with a favorable safety profile reported in preliminary findings.[4]

Another drug being tested is ianalumab, which represents a different approach to calming the overactive immune system. This medication is a type of monoclonal antibody—a laboratory-made protein designed to attach to specific targets on immune cells. Ianalumab targets a receptor called B-cell activating factor receptor (BAFF-R) found on B-cells, a type of white blood cell that produces antibodies. In Sjögren’s syndrome, B-cells play a significant role in the autoimmune attack. By blocking BAFF-R, ianalumab depletes these problematic B-cells, potentially reducing inflammation and symptoms. This drug is administered as an injection and has shown encouraging results in clinical studies.[4]

A third experimental treatment is nipocalimab, another monoclonal antibody that works through yet another mechanism. This drug targets the neonatal Fc receptor (FcRn), which is involved in prolonging the life of antibodies in the bloodstream. By blocking this receptor, nipocalimab helps clear harmful autoantibodies—the antibodies that mistakenly attack the body’s own tissues—from the circulation more quickly. This approach could potentially reduce the autoimmune damage that causes Sjögren’s symptoms. Clinical trials are evaluating whether this mechanism translates into real benefits for patients.[4]

These clinical trials are being conducted at medical centers throughout the United States, Europe, and other regions around the world. Eligibility to participate varies depending on the specific study but generally includes adults with a confirmed diagnosis of Sjögren’s syndrome who meet certain criteria regarding disease severity and symptoms. Some trials specifically seek patients who haven’t responded well to standard treatments, while others may be open to people with different levels of disease activity. Participation in a clinical trial is voluntary and involves careful monitoring by the research team. Patients receive the investigational treatment at no cost and often receive compensation for their time and travel.[10]

⚠️ Important
If you’re interested in participating in a clinical trial, discuss this option with your rheumatologist or healthcare provider. They can help you understand whether trial participation might be appropriate for your situation and can help you find studies that are currently enrolling patients. Remember that participating in research not only gives you potential access to new treatments but also contributes to advancing medical knowledge that could help future patients with Sjögren’s syndrome.[2]

Beyond these specific drugs, researchers are also exploring other innovative approaches. Some studies are investigating whether targeting different inflammatory pathways or using combination therapies might be more effective than single-drug treatments. The heterogeneity of Sjögren’s syndrome—meaning that patients have very different patterns of symptoms and disease involvement—has led scientists to consider whether clustering patients into biologically similar subgroups could improve treatment outcomes. This personalized medicine approach might allow doctors to predict which patients will respond best to which treatments.[10]

While these new therapies are promising, it’s important to maintain realistic expectations. Not every drug that enters clinical trials proves to be effective, and even successful drugs may only work for a subset of patients. The clinical trial process typically takes many years from initial testing to final approval, so these investigational treatments may not be widely available for some time. However, the fact that multiple pharmaceutical companies are now investing in Sjögren’s syndrome research represents a significant shift—this disease, which has historically received less attention than some other autoimmune conditions, is finally getting the research focus it deserves.[10]

Most common treatment methods

  • Moisture replacement therapies
    • Preservative-free artificial tears for dry eyes used throughout the day
    • Eye gels and ointments for nighttime use
    • Saliva substitutes in spray, gel, or lozenge form for dry mouth
    • Oral moisturizers and specialized mouthwashes
    • Vaginal moisturizers for dryness
  • Prescription medications to stimulate gland function
    • Cyclosporine (Restasis) eye drops to increase tear production by reducing eye inflammation
    • Lifitegrast (Xiidra) eye drops to increase tear production
    • Pilocarpine (Salagen) to stimulate saliva and tear production
    • Cevimeline (Evoxac) to increase saliva production
  • Anti-inflammatory medications
    • Over-the-counter NSAIDs like ibuprofen (Advil, Motrin) and naproxen (Aleve) for joint pain
    • Prescription-strength NSAIDs for more severe inflammation
    • Hydroxychloroquine for systemic inflammation and joint symptoms
  • Immune-suppressing medications
    • Short-term corticosteroids (prednisone) for severe joint pain or flares
    • Methotrexate (Rheumatrex) for patients with significant systemic involvement
    • Azathioprine (Imuran) to suppress immune system activity
    • Mycophenolate (Cellcept) for organ involvement
    • Rituximab (Rituxan) for life-threatening cases with major organ damage
  • Supportive therapies
    • Proton-pump inhibitors or H2 blockers for acid reflux and heartburn
    • Intravenous immunoglobulin therapy (IVIG) for nervous system involvement
    • Moisturizing skin creams and emollients for dry skin
  • Investigational treatments in clinical trials
    • Dazodalibep targeting CD40-CD40 ligand pathway to reduce immune activation
    • Ianalumab depleting B-cells by targeting BAFF-R receptor
    • Nipocalimab clearing harmful autoantibodies by blocking FcRn receptor

Ongoing Clinical Trials on Sjogren’s syndrome

  • A study to evaluate the safety of dazodalibep in patients with Sjögren’s Syndrome over a long period of time

    Recruiting

    1 1 1
    Investigated diseases:
    Investigated drugs:
    Belgium Croatia Denmark France Germany Greece +6
  • A Study Testing Imeroprubart for Adults with Primary Sjogren’s Disease with Moderate to Severe Symptoms

    Recruiting

    Investigated diseases:
    Investigated drugs:
    Germany Greece Hungary Italy Poland Romania +1
  • Study of AlloNK and rituximab with cyclophosphamide and fludarabine in adults with relapsing rheumatoid arthritis, inflammatory myopathies, systemic sclerosis, or Sjögren’s disease

    Recruiting

    1 1 1
    Bulgaria France Germany Italy Poland Portugal +2
  • Study on the Effectiveness and Safety of Deucravacitinib for Adults with Active Sjogren’s Syndrome

    Recruiting

    1 1 1
    Investigated diseases:
    Investigated drugs:
    Austria Belgium Bulgaria Finland France Germany +9
  • Study on the Effectiveness of CL-AD-MSC-002 Injections for Dry Mouth in Patients with Sjögren’s Syndrome

    Recruiting

    Investigated diseases:
    Investigated drugs:
    Denmark
  • A study to evaluate the effect of obinutuzumab on removing specific immune cells in the tissues of patients with Sjögren’s syndrome.

    Not yet recruiting

    1 1 1
    Investigated diseases:
    Investigated drugs:
    The Netherlands
  • Study on the Effectiveness and Safety of Ianalumab for Patients with Active Sjögren’s Syndrome

    Not recruiting

    1 1 1
    Investigated diseases:
    Investigated drugs:
    Austria Belgium Czechia France Germany Lithuania +3
  • Efficacy and Safety Evaluation of Dazodalibep in Patients with Moderate-to-Severe Systemic Sjögren’s Syndrome: A Phase 3 Randomized, Double-Blind, Placebo-Controlled Study

    Not recruiting

    1 1
    Investigated diseases:
    Investigated drugs:
    Belgium Croatia Denmark France Germany Greece +6
  • Evaluation of Dazodalibep Efficacy and Safety in Patients with Moderate-to-Severe Sjögren’s Syndrome: A Phase 3 Randomized, Double-Blind, Placebo-Controlled Study

    Not recruiting

    1 1
    Investigated diseases:
    Investigated drugs:
    Belgium Croatia Denmark France Germany Greece +6
  • Study on the Effects of Ianalumab in Patients with Sjögren’s Syndrome

    Not recruiting

    1 1 1
    Investigated diseases:
    France

References

https://www.mayoclinic.org/diseases-conditions/sjogrens-syndrome/symptoms-causes/syc-20353216

https://sjogrens.org/understanding-sjogrens

https://my.clevelandclinic.org/health/diseases/4929-sjogrens-syndrome

https://rheumatology.org/patients/sjogrens-disease

https://www.ncbi.nlm.nih.gov/books/NBK431049/

https://www.nhs.uk/conditions/sjogrens-syndrome/

https://www.nidcr.nih.gov/health-info/sjogrens-disease

https://www.mayoclinic.org/diseases-conditions/sjogrens-syndrome/diagnosis-treatment/drc-20353221

https://sjogrens.org/understanding-sjogrens/treatment

https://pmc.ncbi.nlm.nih.gov/articles/PMC10330372/

FAQ

Is there a cure for Sjögren’s syndrome?

Currently, there is no cure for Sjögren’s syndrome. However, treatments are available that can help manage symptoms, prevent complications, and improve quality of life. Most patients can lead relatively normal lives with appropriate treatment and self-care strategies.[6]

How long does treatment for Sjögren’s syndrome last?

Treatment for Sjögren’s syndrome is typically lifelong because it is a chronic condition. The specific treatments and their intensity may change over time depending on how active your disease is and which symptoms are most problematic. Regular monitoring by your healthcare team helps ensure your treatment plan remains effective.[2]

Can I participate in clinical trials for new Sjögren’s treatments?

Yes, clinical trials for new Sjögren’s syndrome treatments are being conducted in the United States, Europe, and other regions. Eligibility depends on the specific trial requirements, but generally includes adults with confirmed Sjögren’s syndrome. New drugs being tested include dazodalibep, ianalumab, and nipocalimab. Speak with your rheumatologist about whether trial participation might be appropriate for you.[4]

What are the most common side effects of Sjögren’s medications?

Side effects vary by medication type. NSAIDs commonly cause stomach upset and rarely bleeding. Eye drops like cyclosporine may cause burning initially. Saliva-stimulating drugs like pilocarpine and cevimeline can cause sweating, flushing, and increased urination. Immune-suppressing drugs like corticosteroids can cause weight gain, increased blood sugar, and bone thinning with long-term use. Always discuss potential side effects with your doctor.[9]

Will I need to see multiple specialists for Sjögren’s syndrome?

Many patients benefit from care by multiple specialists. A rheumatologist typically coordinates overall treatment, while an ophthalmologist addresses eye concerns, and a dentist manages oral health issues. Depending on your symptoms, you might also see specialists for lungs, kidneys, skin, or nervous system involvement. Having one doctor coordinate your care team is important.[3]

🎯 Key takeaways

  • Treatment for Sjögren’s syndrome is personalized—what works for one person may not work for another, so finding the right combination requires patience and close collaboration with your healthcare team.
  • Simple interventions like preservative-free artificial tears and frequent water sipping form the foundation of symptom management and should not be underestimated despite their simplicity.
  • Prescription medications that stimulate gland function—like pilocarpine for saliva and cyclosporine for tears—can significantly improve quality of life but may take weeks to show full effects.
  • Preventing dental complications requires aggressive preventive care including twice-yearly dental visits and excellent home oral hygiene, because dry mouth dramatically increases cavity risk.
  • Immune-suppressing medications like rituximab are reserved for severe cases with organ involvement because they carry more significant risks and require careful monitoring.
  • Exciting new treatments including dazodalibep, ianalumab, and nipocalimab are currently being tested in clinical trials and work through innovative mechanisms to calm the immune system’s attack.
  • Clinical trials represent both potential access to cutting-edge treatments and an opportunity to contribute to research that could help thousands of future patients with this condition.
  • The growing pharmaceutical interest in Sjögren’s syndrome means that after years of limited treatment options, patients can be hopeful about better therapies becoming available in coming years.