How the Experts Treat Sjögren’s Disease

Leukocytoclastic vasculitis (LCV) should prompt a deeper look. “LCV rarely occurs in isolation in SjD,” Dr. DiRenzo notes. “Screen for cryoglobulins, high immunoglobulin or a possible hematologic malignancy driving it.”

New Drugs, New Hope

After years of no trials in sight, the SjD drug development landscape is finally shifting. Nine drugs have entered phase 2 and phase 3 trials.⁸ One investigational agent generating buzz is dazodalibep, a CD40 ligand antagonist (see p. 21). “Dazodalibep has me very excited,” Dr. Johr says. “Not only did it reduce disease activity, but it improved symptoms. And that’s what our patients want—to feel better,” he concludes.

Conclusion

Treating SjD requires creativity, empathy, nuance and a patient-centered approach. In the absence of FDA-approved therapies, we must blend evidence-based medicine with empiric strategies and shared decision making. And we’ve got to stay tuned. Believe it or not, targeted SjD drugs are coming to a clinic near you … soon.

Samantha C. Shapiro, MD, is a clinician educator who writes for both medical and lay audiences, and practices telerheumatology.

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