What have we learned from clinical trials in primary Sjögren's syndrome about pathogenesis?

Table 1 Biologicals and targets that are used or potentially may be used in primary Sjögren's syndrome

Target	Biological	Structure	Results trials	References
TNFα	Infliximab	Chimeric IgG₁ mAb	No effect in RCT	[15]
TNFα	Etanercept	TNF-Rec1-Fc IgG₁ fusion protein	No effect in (small-size) RCT	[17, 18]
	IFNα	Recombinant IFNα_2a	Increase in unstimulated whole saliva flow (RCT)	[32]
IFNα	Rontalizumab	Recombinant human mAb	Not performed
CD20 B cells	Rituximab	Chimeric IgG₁ mAb	Subjective and objective improvement of salivary flow (RCT), decrease in fatigue (RCT)	[39, 40]
CD22 B cells	Epratizumab	Recombinant human mAb	Increase in unstimulated whole saliva, decrease in fatigue	[45]
BAFF	Belimumab	Recombinant human mAb	In progress
BAFF	Atacicept	TACI-Fc IgG₁ fusion protein	Not performed
BAFF	Briobacept	BAFF-Rec-Fc IgG₁ fusion protein	Not performed
CD28-mediated co-stimulation	Abatacept	CTLA4-Fc IgG₁ fusion protein	In progress

BAFF, B-cell activating factor; CTLA4, cytotoxic T-lymphocyte antigen 4; mAb, monoclonal antibody; RCT, randomized controlled trial; Rec, receptor; TACI, transmembrane activator and calcium-modulating cyclophilin ligand interactor.

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