This protocol applies to patients with Sjögren syndrome who have neutropenia alongside active systemic disease. Treatment of systemic disease should be tailored to organ-specific severity, assessed through the ESSDAI framework.
When Granulocyte colony-stimulating factor (G-CSF) has been used for haematological involvement — specifically neutropenia — and has not achieved a reduction of ≥3 points in the global ESSDAI score, escalation to a different approach is indicated. This protocol defines the next step.
The next line involves consideration of immunosuppressive agents. Several options exist within this class; which to choose, and in what order, depends on the patient's individual profile. The complete selection criteria and sequencing are available in the full protocol.
The primary therapeutic target is a reduction of ≥3 points in the global ESSDAI score — the accepted measure of meaningful systemic disease activity response in Sjögren syndrome.