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Viele DMARDs (\u201edisease-modifying antirheumatic drugs\u201c) und Biologika konnten in Studien keine ausreichende Wirksamkeit zeigen. Gr\u00fcnde hierf\u00fcr sind u.\u00a0a. komplexe immunologische Pathomechanismen sowie eine hohe klinische und immunologische Heterogenit\u00e4t der Patient:innen. In den letzten Jahren kam es jedoch zu deutlichen Fortschritten: Erstmals berichteten Phase-3-Studien 2025 (Ianalumab und Telitacicept) positive Ergebnisse. Grundlage der aktuellen Therapieempfehlungen sind v.\u00a0a. die Leitlinien der European Alliance of Associations for Rheumatology (EULAR, 2020) und die Empfehlungen der British Society for Rheumatology (BSR, 2024). Die Therapie orientiert sich aktuell prim\u00e4r an den f\u00fchrenden Symptomen. Basis ist die konsequente Behandlung der Sicca-Symptomatik (Augen- und Mundpflege, ggf. Pilocarpin). Extraglandul\u00e4re Manifestationen werden \u00fcberwiegend off-label mit konventionellen DMARDs behandelt; bei schweren Verl\u00e4ufen kommen Rituximab, seltener Cyclophosphamid oder intraven\u00f6se Immunoglobuline (IVIG) zum Einsatz. Neue Therapieans\u00e4tze zeigen erstmals eine anhaltende Reduktion der Krankheitsaktivit\u00e4t: Besonders B\u2011Zell-gerichtete Therapien (Ianalumab, Telitacicept), FcRn-Inhibitoren (Nipocalimab, Efgartigimod), CD40\/CD40L-Blockade, Kinase-Inhibitoren und weitere immunmodulatorische Strategien erzielten in kontrollierten Studien signifikante Verbesserungen im ESSDAI (EULAR Sj\u00f6gren\u2019s Syndrome Disease Activity Index) und teils im ESSPRI (EULAR Sj\u00f6gren\u2019s Syndrome Patient-Reported Index) bei akzeptablem Sicherheitsprofil. W\u00e4hrend Basisma\u00dfnahmen unverzichtbar bleiben, markieren neue zielgerichtete Therapien einen Wendepunkt in der SjD-Behandlung. Insbesondere B\u2011Zell- und FcRn-gerichtete Ans\u00e4tze er\u00f6ffnen erstmals die Perspektive auf evidenzbasierte systemische Therapien \u00fcber die reine Symptomkontrolle hinaus.<\/jats:p>","DOI":"10.1007\/s00393-026-01815-3","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T12:11:20Z","timestamp":1777291880000},"page":"536-544","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Aktuelle Therapien, absehbare Newcomer und neue Therapieans\u00e4tze f\u00fcr die Sj\u00f6gren-Erkrankung","Current treatment, foreseeable newcomer and new treatment approaches for Sj\u00f6gren\u2019s disease"],"prefix":"10.1007","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0736-6243","authenticated-orcid":false,"given":"Diana","family":"Ernst","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1556-790X","authenticated-orcid":false,"given":"Nadine","family":"Zehrfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"1815_CR1","doi-asserted-by":"publisher","unstructured":"van Nimwegen JF, Mossel E, van Zuiden GS, Wijnsma RF, Delli K, Stel AJ, van der Vegt B, Haacke EA, Olie L, Los LI, Verstappen GM, Pringle SA, Spijkervet FKL, Kroese FGM, Vissink A, Arends S, Bootsma H (2020) Abatacept treatment for patients with early active primary Sj\u00f6gren\u2019s syndrome: a\u00a0single-centre, randomised, double-blind, placebo-controlled, phase\u00a03\u00a0trial 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