{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T16:49:09Z","timestamp":1793638149509,"version":"4.5.1"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Z Rheumatol"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1007\/s00393-026-01824-2","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T05:19:19Z","timestamp":1778476759000},"page":"632-641","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy and safety of pharmacological treatment for Sj\u00f6gren\u2019s disease: a\u00a0network meta-analysis","Wirksamkeit und Sicherheit der medikament\u00f6sen Behandlung der Sj\u00f6gren-Erkrankung: eine Netzwerk-Metaanalyse"],"prefix":"10.1007","volume":"85","author":[{"given":"Meilv","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengnan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suxian","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"1824_CR1","doi-asserted-by":"crossref","unstructured":"Anonymous (2024) KDIGO 2024 Clinical Practice Guideline for the management of LUPUS NEPHRITIS. Kidney Int 105:S1\u2013s69","DOI":"10.1016\/j.kint.2023.09.002"},{"key":"1824_CR2","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1136\/annrheumdis-2020-218599","volume":"80","author":"AN Baer","year":"2021","unstructured":"Baer\u00a0AN, Gottenberg\u00a0JE, St Clair\u00a0EW et\u00a0al (2021) Efficacy and safety of abatacept in active primary Sj\u00f6gren\u2019s syndrome: results of a phase III, randomised, placebo-controlled trial. Ann Rheum Dis 80:339\u2013348","journal-title":"Ann Rheum Dis"},{"key":"1824_CR3","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-15-21","volume":"15","author":"S Brown","year":"2014","unstructured":"Brown\u00a0S, Navarro Coy\u00a0N, Pitzalis\u00a0C et\u00a0al (2014) The TRACTISS protocol: a randomised double blind placebo controlled clinical trial of anti-B-cell therapy in patients with primary Sj\u00f6gren\u2019s Syndrome. BMC Musculoskelet Disord 15:21","journal-title":"BMC Musculoskelet Disord"},{"key":"1824_CR4","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1136\/ard-2023-224691","volume":"83","author":"T D\u00f6rner","year":"2024","unstructured":"D\u00f6rner\u00a0T, Kaul\u00a0M, Sz\u00e1nt\u00f3\u00a0A et\u00a0al (2024) Efficacy and safety of remibrutinib, a selective potent oral BTK inhibitor, in Sj\u00f6gren\u2019s syndrome: results from a randomised, double-blind, placebo-controlled phase 2 trial. Ann Rheum Dis 83:360\u2013371","journal-title":"Ann Rheum Dis"},{"key":"1824_CR5","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1136\/annrheumdis-2018-214720","volume":"78","author":"T D\u00f6rner","year":"2019","unstructured":"D\u00f6rner\u00a0T, Posch\u00a0MG, Li\u00a0Y et\u00a0al (2019) Treatment of primary Sj\u00f6gren\u2019s syndrome with ianalumab (VAY736) targeting B cells by BAFF receptor blockade coupled with enhanced, antibody-dependent cellular cytotoxicity. Ann Rheum Dis 78:641\u2013647","journal-title":"Ann Rheum Dis"},{"key":"1824_CR6","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1136\/annrheumdis-2020-218467","volume":"80","author":"R Felten","year":"2021","unstructured":"Felten\u00a0R, Devauchelle-Pensec\u00a0V, Seror\u00a0R et\u00a0al (2021) Interleukin 6 receptor inhibition in primary Sj\u00f6gren syndrome: a multicentre double-blind randomised placebo-controlled trial. Ann Rheum Dis 80:329\u2013338","journal-title":"Ann Rheum Dis"},{"key":"1824_CR7","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2019.00550","volume":"10","author":"Z Feng","year":"2019","unstructured":"Feng\u00a0Z, Zhang\u00a0BQ, Zhu\u00a0YM et\u00a0al (2019) The Effectiveness and Safety of Total Glucosides of Paeony in Primary Sj\u00f6gren\u2019s Syndrome: A Systematic Review and Meta-Analysis. Front Pharmacol 10:550","journal-title":"Front Pharmacol"},{"key":"1824_CR8","doi-asserted-by":"publisher","first-page":"e142","DOI":"10.1016\/S2665-9913(19)30135-3","volume":"2","author":"BA Fisher","year":"2020","unstructured":"Fisher\u00a0BA, Szanto\u00a0A, Ng\u00a0WF et\u00a0al (2020) Assessment of the anti-CD40 antibody iscalimab in patients with primary Sj\u00f6gren\u2019s syndrome: a multicentre, randomised, double-blind, placebo-controlled, proof-of-concept study. Lancet Rheumatol 2:e142\u2013e152","journal-title":"Lancet Rheumatol"},{"key":"1824_CR9","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/S0140-6736(05)66990-5","volume":"366","author":"RI Fox","year":"2005","unstructured":"Fox\u00a0RI (2005) Sj\u00f6gren\u2019s syndrome. Lancet 366:321\u2013331","journal-title":"Lancet"},{"key":"1824_CR10","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1097\/00005792-200207000-00003","volume":"81","author":"M Garc\u00eda-Carrasco","year":"2002","unstructured":"Garc\u00eda-Carrasco\u00a0M, Ramos-Casals\u00a0M, Rosas\u00a0J et\u00a0al (2002) Primary Sj\u00f6gren syndrome: clinical and immunologic disease patterns in a cohort of 400 patients. Medicine (Baltimore) 81:270\u2013280","journal-title":"Medicine (Baltimore)"},{"key":"1824_CR11","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1080\/08923973.2019.1593448","volume":"41","author":"K Garlapati","year":"2019","unstructured":"Garlapati\u00a0K, Kammari\u00a0A, Badam\u00a0RK et\u00a0al (2019) Meta-analysis on pharmacological therapies in the management of xerostomia in patients with Sjogren\u2019s syndrome. Immunopharmacol Immunotoxicol 41:312\u2013318","journal-title":"Immunopharmacol Immunotoxicol"},{"key":"1824_CR12","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1136\/annrheumdis-2012-202293","volume":"72","author":"JE Gottenberg","year":"2013","unstructured":"Gottenberg\u00a0JE, Cinquetti\u00a0G, Larroche\u00a0C et\u00a0al (2013) Efficacy of rituximab in systemic manifestations of primary Sjogren\u2019s syndrome: results in 78 patients of the AutoImmune and Rituximab registry. Ann Rheum Dis 72:1026\u20131031","journal-title":"Ann Rheum Dis"},{"key":"1824_CR13","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1001\/jama.2014.7682","volume":"312","author":"JE Gottenberg","year":"2014","unstructured":"Gottenberg\u00a0JE, Ravaud\u00a0P, Pu\u00e9chal\u00a0X et\u00a0al (2014) Effects of hydroxychloroquine on symptomatic improvement in primary Sj\u00f6gren syndrome: the JOQUER randomized clinical trial. Jama 312:249\u2013258","journal-title":"Jama"},{"key":"1824_CR14","first-page":"317","volume":"35","author":"EA Haacke","year":"2017","unstructured":"Haacke\u00a0EA, Van Der Vegt\u00a0B, Meiners\u00a0PM et\u00a0al (2017) Abatacept treatment of patients with primary Sj\u00f6gren\u2019s syndrome results in a decrease of germinal centres in salivary gland tissue. Clin Exp Rheumatol 35:317\u2013320","journal-title":"Clin Exp Rheumatol"},{"key":"1824_CR15","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.41451","volume":"5","author":"J He","year":"2022","unstructured":"He\u00a0J, Chen\u00a0J, Miao\u00a0M et\u00a0al (2022) Efficacy and Safety of Low-Dose Interleukin 2 for Primary Sj\u00f6gren Syndrome: A Randomized Clinical Trial. JAMA Netw Open 5:e2241451","journal-title":"JAMA Netw Open"},{"key":"1824_CR16","doi-asserted-by":"publisher","first-page":"3059","DOI":"10.1007\/s10792-020-01490-6","volume":"40","author":"W Jiang","year":"2020","unstructured":"Jiang\u00a0W, Zhang\u00a0L, Zhao\u00a0Y et\u00a0al (2020) The efficacy and mechanism for action of iguratimod in primary Sj\u00f6gren\u2019s syndrome patients. Int Ophthalmol 40:3059\u20133065","journal-title":"Int Ophthalmol"},{"key":"1824_CR17","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1007\/s10875-005-4091-5","volume":"25","author":"MV Jonsson","year":"2005","unstructured":"Jonsson\u00a0MV, Szodoray\u00a0P, Jellestad\u00a0S et\u00a0al (2005) Association between circulating levels of the novel TNF family members APRIL and BAFF and lymphoid organization in primary Sj\u00f6gren\u2019s syndrome. J\u00a0Clin Immunol 25:189\u2013201","journal-title":"J Clin Immunol"},{"key":"1824_CR18","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.1093\/rheumatology\/keaa410","volume":"60","author":"M Juarez","year":"2021","unstructured":"Juarez\u00a0M, Diaz\u00a0N, Johnston\u00a0GI et\u00a0al (2021) A phase 2 randomized, double-blind, placebo-controlled, proof-of-concept study of oral seletalisib in primary Sj\u00f6gren\u2019s syndrome. Rheumatology (Oxford) 60:1364\u20131375","journal-title":"Rheumatology (Oxford)"},{"key":"1824_CR19","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.autrev.2009.07.002","volume":"9","author":"L Kov\u00e1cs","year":"2010","unstructured":"Kov\u00e1cs\u00a0L, Szodoray\u00a0P, Kiss\u00a0E (2010) Secondary tumours in Sj\u00f6gren\u2019s syndrome. Autoimmun Rev 9:203\u2013206","journal-title":"Autoimmun Rev"},{"key":"1824_CR20","doi-asserted-by":"crossref","unstructured":"Mariette X, Barone F, Baldini C et\u00a0al. (2022) A randomized, phase\u00a0II study of sequential belimumab and rituximab in primary Sj\u00f6gren\u2019s syndrome. JCI Insight 7","DOI":"10.1172\/jci.insight.163030"},{"key":"1824_CR21","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1136\/annrheumdis-2013-203991","volume":"74","author":"X Mariette","year":"2015","unstructured":"Mariette\u00a0X, Seror\u00a0R, Quartuccio\u00a0L et\u00a0al (2015) Efficacy and safety of belimumab in primary Sj\u00f6gren\u2019s syndrome: results of the BELISS open-label phase II study. Ann Rheum Dis 74:526\u2013531","journal-title":"Ann Rheum Dis"},{"key":"1824_CR22","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1080\/14397595.2018.1460230","volume":"29","author":"T Mimori","year":"2019","unstructured":"Mimori\u00a0T, Harigai\u00a0M, Atsumi\u00a0T et\u00a0al (2019) Safety and effectiveness of iguratimod in patients with rheumatoid arthritis: Final report of a 52-week, multicenter postmarketing surveillance study. Mod Rheumatol 29:314\u2013323","journal-title":"Mod Rheumatol"},{"key":"1824_CR23","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1038\/nrrheum.2013.110","volume":"9","author":"G Nocturne","year":"2013","unstructured":"Nocturne\u00a0G, Mariette\u00a0X (2013) Advances in understanding the pathogenesis of primary Sj\u00f6gren\u2019s syndrome. Nat Rev Rheumatol 9:544\u2013556","journal-title":"Nat Rev Rheumatol"},{"key":"1824_CR24","doi-asserted-by":"crossref","unstructured":"Page MJ, Mckenzie JE, Bossuyt PM et\u00a0al. (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj 372:n71","DOI":"10.1136\/bmj.n71"},{"key":"1824_CR25","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1002\/art.41489","volume":"73","author":"J Posada","year":"2021","unstructured":"Posada\u00a0J, Valadkhan\u00a0S, Burge\u00a0D et\u00a0al (2021) Improvement of Severe Fatigue Following Nuclease Therapy in Patients With Primary Sj\u00f6gren\u2019s Syndrome: A Randomized Clinical Trial. Arthritis Rheumatol 73:143\u2013150","journal-title":"Arthritis Rheumatol"},{"key":"1824_CR26","doi-asserted-by":"publisher","first-page":"4797","DOI":"10.1093\/rheumatology\/keac167","volume":"61","author":"E Price","year":"2022","unstructured":"Price\u00a0E, Bombardieri\u00a0M, Kivitz\u00a0A et\u00a0al (2022) Safety and efficacy of filgotinib, lanraplenib and tirabrutinib in Sj\u00f6gren\u2019s syndrome: a randomized, phase 2, double-blind, placebo-controlled study. Rheumatology (Oxford) 61:4797\u20134808","journal-title":"Rheumatology (Oxford)"},{"key":"1824_CR27","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.pharmthera.2017.10.019","volume":"184","author":"S Retamozo","year":"2018","unstructured":"Retamozo\u00a0S, Flores-Chavez\u00a0A, Consuegra-Fern\u00e1ndez\u00a0M et\u00a0al (2018) Cytokines as therapeutic targets in primary Sj\u00f6gren syndrome. Pharmacol Ther 184:81\u201397","journal-title":"Pharmacol Ther"},{"key":"1824_CR28","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1136\/annrheumdis-2021-222054","volume":"81","author":"R Seror","year":"2022","unstructured":"Seror\u00a0R, Baron\u00a0G, Camus\u00a0M et\u00a0al (2022) Development and preliminary validation of the Sj\u00f6gren\u2019s Tool for Assessing Response (STAR): a consensual composite score for assessing treatment effect in primary Sj\u00f6gren\u2019s syndrome. Ann Rheum Dis 81:979\u2013989","journal-title":"Ann Rheum Dis"},{"key":"1824_CR29","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1136\/ard.2010.143743","volume":"70","author":"R Seror","year":"2011","unstructured":"Seror\u00a0R, Ravaud\u00a0P, Mariette\u00a0X et\u00a0al (2011) EULAR Sjogren\u2019s Syndrome Patient Reported Index (ESSPRI): development of a consensus patient index for primary Sjogren\u2019s syndrome. Ann Rheum Dis 70:968\u2013972","journal-title":"Ann Rheum Dis"},{"key":"1824_CR30","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1002\/art.39859","volume":"69","author":"CH Shiboski","year":"2017","unstructured":"Shiboski\u00a0CH, Shiboski\u00a0SC, Seror\u00a0R et\u00a0al (2017) 2016 American College of Rheumatology\/European League Against Rheumatism Classification Criteria for Primary Sj\u00f6gren\u2019s Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts. Arthritis Rheumatol 69:35\u201345","journal-title":"Arthritis Rheumatol"},{"key":"1824_CR31","doi-asserted-by":"crossref","unstructured":"Srivastava A, Makarenkova HP (2020) Innate Immunity and Biological Therapies for the Treatment of Sj\u00f6gren\u2019s Syndrome. Int J Mol Sci 21","DOI":"10.3390\/ijms21239172"},{"key":"1824_CR32","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1038\/s41591-024-03009-3","volume":"30","author":"EW St Clair","year":"2024","unstructured":"St Clair\u00a0EW, Baer\u00a0AN, Ng\u00a0WF et\u00a0al (2024) CD40 ligand antagonist dazodalibep in Sj\u00f6gren\u2019s disease: a randomized, double-blinded, placebo-controlled, phase 2 trial. Nat Med 30:1583\u20131592","journal-title":"Nat Med"},{"key":"1824_CR33","doi-asserted-by":"publisher","first-page":"1470","DOI":"10.1002\/art.40513","volume":"70","author":"EW St Clair","year":"2018","unstructured":"St Clair\u00a0EW, Baer\u00a0AN, Wei\u00a0C et\u00a0al (2018) Clinical Efficacy and Safety of Baminercept, a Lymphotoxin \u03b2 Receptor Fusion Protein, in Primary Sj\u00f6gren\u2019s Syndrome: Results From a Phase II Randomized, Double-Blind, Placebo-Controlled Trial. Arthritis Rheumatol 70:1470\u20131480","journal-title":"Arthritis Rheumatol"},{"key":"1824_CR34","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898","volume":"366","author":"J Sterne","year":"2019","unstructured":"Sterne\u00a0J, Savovi\u0107\u00a0J, Page\u00a0MJ et\u00a0al (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. Bmj 366:l4898","journal-title":"Bmj"},{"key":"1824_CR35","doi-asserted-by":"publisher","first-page":"e260","DOI":"10.1016\/S2665-9913(20)30057-6","volume":"2","author":"EHM Van Der Heijden","year":"2020","unstructured":"Van Der Heijden\u00a0EHM, Blokland\u00a0SLM, Hillen\u00a0MR et\u00a0al (2020) Leflunomide-hydroxychloroquine combination therapy in patients with primary Sj\u00f6gren\u2019s syndrome (RepurpSS-I): a placebo-controlled, double-blinded, randomised clinical trial. Lancet Rheumatol 2:e260\u2013e269","journal-title":"Lancet Rheumatol"},{"key":"1824_CR36","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1002\/jrsm.1054","volume":"3","author":"G Van Valkenhoef","year":"2012","unstructured":"Van Valkenhoef\u00a0G, Lu\u00a0G, De Brock\u00a0B et\u00a0al (2012) Automating network meta-analysis. Res Synth Methods 3:285\u2013299","journal-title":"Res Synth Methods"},{"key":"1824_CR37","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1093\/rheumatology\/kead265","volume":"63","author":"D Xu","year":"2024","unstructured":"Xu\u00a0D, Fang\u00a0J, Zhang\u00a0S et\u00a0al (2024) Efficacy and safety of telitacicept in primary Sj\u00f6gren\u2019s syndrome: a randomized, double-blind, placebo-controlled, phase 2 trial. Rheumatology (Oxford) 63:698\u2013705","journal-title":"Rheumatology (Oxford)"}],"container-title":["Zeitschrift f\u00fcr Rheumatologie"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00393-026-01824-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00393-026-01824-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00393-026-01824-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:26:45Z","timestamp":1791458805000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00393-026-01824-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,11]]},"references-count":37,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["1824"],"URL":"https:\/\/doi.org\/10.1007\/s00393-026-01824-2","relation":{},"ISSN":["0340-1855","1435-1250"],"issn-type":[{"value":"0340-1855","type":"print"},{"value":"1435-1250","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,11]]},"assertion":[{"value":"26 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"M.\u00a0Yang, Y.\u00a0Lu, S.\u00a0Wang and S.\u00a0Lin declare that they have no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval is not applicable for this is a review article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}}]}}