In this segment, the panel discusses how clinicians sequence treatments for Sjögren’s Disease (SjD) based on disease severity, symptom burden, and organ involvement. They emphasize starting with symptom-focused management, addressing dryness, fatigue, and musculoskeletal pain—before moving to systemic therapy. Decisions to escalate treatment depend on factors such as persistent inflammatory arthritis, neuropathy, lung disease, or signs of high B-cell activation. The conversation highlights the importance of distinguishing patients who benefit from conservative care from those who require immunomodulators or biologic therapy, noting that timing is essential to prevent progression.

The panel also addresses how overlapping autoimmune diseases, like rheumatoid arthritis or lupus, influence treatment choice and may accelerate the need for systemic approaches. Despite available therapies, significant unmet needs remain—particularly in addressing fatigue, preventing glandular decline, and modifying disease course. The group underscores the need for targeted, disease-modifying treatments and continued clinical research to improve long-term outcomes.