The historical classification of Sjögren's syndrome into "primary" and "secondary" categories is outdated and misleading.

The evidence suggests that Sjögren's, whether it appears alone or with another autoimmune disease, is fundamentally the same condition.

The term "secondary" not only diminishes the impact of Sjögren's but also hinders research and limits treatment options for those affected.

Sjögren's: A Standalone Powerhouse

Sjögren's is a complex and often debilitating autoimmune disease that deserves recognition and research in its own right.

The term "secondary" implies that Sjögren's is somehow less important or less severe when it occurs alongside other autoimmune conditions. This is simply not true.

Sjögren's can significantly impact quality of life, even more so than other systemic autoimmune diseases in certain aspects.

The focus on "primary" Sjögren's has led to a neglect of research and treatment options for those with co-occurring conditions, which is unacceptable.

Unraveling the Complexities of Sjögren's

The relationship between Sjögren's and other autoimmune diseases is complex and multifaceted.

While the presence of another autoimmune disease doesn't change the fundamental nature of Sjögren's, it can influence its clinical presentation and potentially even the course of the associated disease.

For example, individuals with rheumatoid arthritis and Sjögren's may experience more aggressive joint damage, while those with lupus and Sjögren's may respond better to certain B cell-targeted therapies.

These observations highlight the need for further research into the interplay between Sjögren's and other autoimmune diseases.

Breaking Down Barriers in Research and Treatment

The exclusion of individuals with "secondary" Sjögren's from clinical trials and the development of classification criteria has created significant barriers to research and treatment.

This has resulted in a lack of evidence-based treatment options for those with co-occurring conditions.

We need to move towards inclusive research practices that consider the full spectrum of Sjögren's, regardless of whether it appears alone or with other autoimmune diseases.

A Call for Change: Embracing a New Terminology

It's time to abandon the outdated and harmful term "secondary" Sjögren's. Instead, we propose using the term "Sjögren's in association with..." to acknowledge the presence of other autoimmune diseases without diminishing the significance of Sjögren's itself.

This change in terminology will not only promote more inclusive research and treatment practices but also empower individuals with Sjögren's to advocate for their needs and access the care they deserve.

The Future of Sjögren's: A Unified Approach

The future of Sjögren's research and treatment lies in a unified approach that recognizes the complexity of the disease and embraces the diversity of those affected.

By breaking down the artificial barriers between "primary" and "secondary" Sjögren's, we can pave the way for a more comprehensive understanding of the disease and develop more effective and personalized treatment options for all.

Reference: doi:10.1093/rheumatology/keaa009