RHO is a phase 2 proof-of-concept RCT of the FcRn antagonist efgartigimod in Sjögren’s disease, testing whether removing pathogenic IgG autoantibodies improves disease. It met its exploratory objective (CRESS response 45.5% vs 11.1% at week 24) with deep, selective IgG reduction — but systemic activity improved while patient-reported symptoms did not, and the tiny sample means this justifies phase 3, not practice change.
A 2026 narrative review arguing that B cells are the single through-line of Sjögren disease — connecting autoantibodies, glandular pathology, the highest lymphoma risk of any autoimmune disease, and the emerging drug pipeline. Endotyping by B-cell activity may identify who develops lymphoma and who responds to B-cell-targeted therapy, as newer BAFF/APRIL, CD40L, BTK and FcRn agents succeed where rituximab failed.
The 2026 Sjögren’s Foundation clinical practice guideline for peripheral nervous system involvement in Sjögren’s disease — an aligned neuro-rheumatology nomenclature, 31 evaluation good-practice statements, and 20 treatment recommendations (6 strong), covering mononeuropathies, polyneuropathies, and autonomic disease. Evidence is very low certainty, so most guidance rests on expert consensus.
RepurpSS-II is a phase 2b, placebo-controlled RCT of leflunomide plus hydroxychloroquine in active systemic Sjögren’s disease, given without any background immunomodulatory therapy. The combination met its primary endpoint — a clinically meaningful ESSDAI improvement (−4.14) at 24 weeks, replicating RepurpSS-I — but dryness and patient-reported symptoms (ESSPRI) did not separate from placebo.