Sjögren’s disease (pronounced “SHOW-grins”) is a chronic autoimmune condition best known for causing dry eyes and a dry mouth. That description undersells it. Sjögren’s can affect the whole body, cause profound fatigue, and take years to diagnose. For decades there has been no approved drug that treats the disease itself — something that may finally be about to change. This guide covers the essentials.

What happens in Sjögren’s

In Sjögren’s, the immune system mistakenly attacks the body’s moisture-producing glands, above all the tear glands and salivary glands. Immune cells infiltrate the glands, inflame them, and gradually reduce their output. B cells, the immune cells that make antibodies, are unusually active, producing autoantibodies that are a hallmark of the disease. The cause is not fully understood; it appears to involve inherited susceptibility plus a trigger, possibly a viral infection.

Who gets it

Sjögren’s is among the more common autoimmune diseases; patient organizations estimate it affects up to around four million Americans. About nine in ten patients are women, and it is most often diagnosed in the 40s and 50s, though it can occur at any age. It can appear on its own or alongside another autoimmune disease, such as rheumatoid arthritis or lupus. It was long called “Sjögren’s syndrome”; “disease” is now preferred to reflect that it is a distinct, serious condition.

Symptoms

The classic pair are dry eyes — gritty, burning, as if there were sand in them — and a dry mouth, which makes it hard to swallow dry food, speak for long, or sleep through the night without water. Lack of saliva also leads to rapid tooth decay and oral infections. Many people also have:

  • Fatigue, often the most disabling symptom;
  • Joint and muscle pain;
  • Swollen salivary glands, in front of the ears or under the jaw;
  • Dryness elsewhere: skin, nose, throat and vagina;
  • “Brain fog” and difficulty concentrating.

When it goes beyond dryness

In a substantial minority of patients, Sjögren’s affects other organs: the lungs (scarring or inflammation), kidneys, nerves (numbness, tingling or burning pain in the hands and feet), skin and blood vessels. People with Sjögren’s also have a higher risk of lymphoma, a cancer of immune cells, than the general population. The risk for any individual is still low, but persistent, firm swelling of a salivary gland or lymph nodes should always be checked.

Why diagnosis takes so long

Dryness and tiredness are common and have many causes, including medications and aging, so Sjögren’s is frequently missed; patients often wait several years for a diagnosis. Doctors look for a combination of findings:

  • Blood tests for autoantibodies, especially anti-SSA (Ro);
  • Eye tests: a paper strip to measure tear production (Schirmer test) and dyes that reveal damage to the eye’s surface;
  • Saliva flow measurement;
  • a lip biopsy, in which a few tiny salivary glands are removed from inside the lower lip to look for clusters of immune cells.

No single test is definitive, which is why the diagnosis is usually made by a rheumatologist, often working with an eye doctor and dentist.

How it is treated today

Current treatment is aimed at symptoms. For the eyes: artificial tears, prescription anti-inflammatory drops such as cyclosporine or lifitegrast, and tiny plugs that block tear drainage. For the mouth: frequent sips of water, saliva substitutes, sugar-free gum, and tablets such as pilocarpine or cevimeline that stimulate saliva. Meticulous dental care with high-fluoride products is essential. Hydroxychloroquine is often used for joint pain and fatigue, although evidence for it is limited. When organs are involved, doctors turn to steroids and immune-suppressing drugs borrowed from other diseases, used off-label.

The first targeted drugs

After many failed trials, several drugs have now succeeded in late-stage studies by targeting the overactive immune pathways directly:

  • Ianalumab (Novartis) depletes B cells and blocks a survival signal they depend on. It improved disease activity in two Phase 3 trials of nearly 800 patients, received FDA Breakthrough Therapy designation in January 2026, and has been submitted to regulators.
  • Dazodalibep (Amgen) blocks communication between T cells and B cells; it met its goal in a Phase 3 trial.
  • Nipocalimab (Johnson & Johnson) lowers levels of harmful antibodies and holds FDA Fast Track and Breakthrough designations.
  • Telitacicept has been approved for Sjögren’s in China, with global trials under way.

At the time of writing, none is approved in the US. If one is, it would be the first treatment approved specifically for Sjögren’s disease. A note of realism: these trials mainly measured overall disease activity; how much the drugs improve dryness and fatigue, the symptoms patients care most about, is still being worked out.

Living with Sjögren’s

Day-to-day management makes a real difference: humidifiers, avoiding medicines that worsen dryness where possible, regular dental and eye check-ups, pacing activity around fatigue, and staying up to date with vaccinations. Patient organizations offer practical support and can help people find clinical trials. Anyone with persistent dry eyes and mouth, especially with fatigue or joint pain, should ask their doctor whether Sjögren’s could be the cause. This explainer is general information, not medical advice.