Disease overview

Alterations

Molecular (A)

Clinical (B–E)

Direct drugs

Via biomarker

Natural agents

Natural products

Merged ranked

Sources: Open Targets, HPO, ClinicalTrials.gov, DGIdb, ChEMBL, PubMed Literature, GreenMedInfo, Examine.com · Pipeline phase 7 · Updated 2026-07-06

Remission & chronicity

Spontaneous remission

Chronic and progressive; glandular dysfunction (dry eyes/mouth) irreversible in most; fatigue and systemic features fluctuate; lymphoma risk 5-15x general population; spontaneous full remission rare

Best-intervention remission

Hydroxychloroquine: limited systemic benefit; rituximab: parotid gland improvement and fatigue in some trials but primary endpoint failure in Phase 3 (TEARS, TRACTISS); no disease-modifying therapy approved; best outcomes with early systematic sicca management

Drug-free remission

—

Relapse after remission

—

Chronicity

—

Gap size

Very large — no approved disease-modifying therapy; symptomatic management only for glandular features

Primary barrier

biological + access

Barrier detail: Sjögren's research has been hampered by heterogeneous disease and lack of validated endpoints; rituximab failed multiple Phase 3 trials despite positive Phase 2 data (endpoint selection problem); anti-Ro/SSA positivity enriches trials but treatment effects still modest; diagnosis itself is delayed 4-7 years on average

Last SoC change: 2023 — iscalimab (anti-CD40) Phase 3 data; no disease-modifying therapy approved; EULAR recommendations updated 2020; hydroxychloroquine as standard systemic agent since 1990s

Remission data layers: disease_db_100 · source-locked manual data · confidence: high

Identifiers: —

Alterations

10 total · Types A (molecular) through E (functional)

Name	Type	Subtype	Direction	Frequency	Evidence	Sources	Links
Change in corneal / conjunctival staining score using the National Eye Institute/Industry(NEI) Industry Grading System	Scales & PROs	Clinical scale	—	—	Emerging	ClinicalTrials.gov	—
ESSDAI	Lab / Clinical	Lab value	—	—	Emerging	ClinicalTrials.gov	—
EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI)	Scales & PROs	Clinical scale	—	—	Emerging	ClinicalTrials.gov	—
Health assessment questionnaire (HAQ)	Scales & PROs	Clinical scale	—	—	Emerging	ClinicalTrials.gov	—
Number of Participants With Adverse Events (AEs)	Lab / Clinical	Lab value	—	—	Emerging	ClinicalTrials.gov	—
Ocular Surface Disease Index (OSDI)	Scales & PROs	Clinical scale	—	—	Emerging	ClinicalTrials.gov	—
Percent of Participants With ACR50 Response at Week 12 Compared to Baseline - RA	Lab / Clinical	Lab value	—	—	Emerging	ClinicalTrials.gov	—
Pittsburgh Sleep Quality Index	Scales & PROs	Clinical scale	—	—	Emerging	ClinicalTrials.gov	—
Visual Analog Scale (VAS)	Scales & PROs	Clinical scale	—	—	Emerging	ClinicalTrials.gov	—
Xerostomia Inventory	Lab / Clinical	Lab value	—	—	Emerging	ClinicalTrials.gov	—

Therapeutics

Direct disease associations, biomarker-linked drugs, OSMF narrative-review natural agents, merged ranking, and clinical trial / literature evidence (top agents)

No therapeutics in this section.

Natural Products

18 natural products with the same evidence schema as repurposed drugs — registry trials, PubMed literature, and reference links (pipeline-ranked)

Reference lookups: GreenMedInfo · Examine.com

Drug	Type	Phase	Evidence	Score	Trials & literature	Sources	Links
Omega-3 Fatty Acids Natural product Human Study Data support pro- and anti-inflammatory roles within EFA metabolism Commentary Essential fatty acid supplementation may be beneficial in treating Sjog…	Nutraceutical	Phase III	Emerging	10	1 trials View evidence Registry trials NCT05005806 — Fish Oil (Omega 3 ) in Sjogren's Syndrome (COMPLETED) PHASE2, PHASE3 CT.gov search · Cochrane · PubMed	GreenMedInfo	PubChem GreenMedInfo
Curcumin Natural product Systematic review Research progress on traditional Chinese medicine compounds in autoimmu… Animal Study These studies show that ultrasoluble curcumin and turmeric could prove… In Vitro Study Heat-solubilized curry spice curcumin inhibits antibody-antigen interac…	Food compound	Preclinical	Emerging	7	5 pubs View evidence Published literature Systematic review Research progress on traditional Chinese medicine compounds in autoimmune-related skin diseases (Frontiers in immunology, 2025) CT.gov search · Cochrane · PubMed	GreenMedInfo	PubChem GreenMedInfo
Egcg Natural product Human Study An adverse immune reaction to wheat proteins is more commonly apparent… Human Study Cardamonin is a potential candidate for controlling inflammation during… Human Study Celiac disease prevalance is significantly higher in those diagnosed wi…	Food compound	Preclinical	Emerging	7	9 pubs View evidence CT.gov search · Cochrane · PubMed	GreenMedInfo	PubChem GreenMedInfo
Lactobacillus Natural product Clinical trial publication Probiotics as a prophylaxis to prevent oral candidiasis in patients wit… Clinical trial publication Impact of wearing an intra-oral lubricating device on oral health in dr… Human Study An adverse immune reaction to wheat proteins is more commonly apparent…	Probiotic	Preclinical	Emerging	7	2 Trial pubs 2 RCT View evidence Published literature Clinical trial publication Probiotics as a prophylaxis to prevent oral candidiasis in patients with Sjogren's syndrome: a double-blinded, placebo-controlled, randomized trial (Rheumatology international, 2020) Clinical trial publication Impact of wearing an intra-oral lubricating device on oral health in dry mouth patients (Oral diseases, 2006) CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
Melatonin Natural product Human Study Pycnogenol supplementation in patients with Sjogren syndromein a remiss… Human Study Supplementation with Pycnogenol® may offer advantages and management po… Commentary Essential fatty acid supplementation may be beneficial in treating Sjog…	Nutraceutical	Preclinical	Emerging	7	6 pubs View evidence CT.gov search · Cochrane · PubMed	GreenMedInfo	PubChem GreenMedInfo
Peony Natural product Clinical trial publication The efficacy and safety of total glucosides of peony in the treatment o… Human Study An adverse immune reaction to wheat proteins is more commonly apparent… Human Study Cardamonin is a potential candidate for controlling inflammation during…	Nutraceutical	Preclinical	Emerging	0	1 Trial pubs 1 RCT View evidence Published literature Clinical trial publication The efficacy and safety of total glucosides of peony in the treatment of primary Sjögren's syndrome: a multi-center, randomized, double-blinded, placebo-controlled clinical trial (Clinical rheumatology, 2019) CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
EGCG (Epigallocatechin Gallate) Natural product Human Study An adverse immune reaction to wheat proteins is more commonly apparent… Human Study Cardamonin is a potential candidate for controlling inflammation during… Human Study Celiac disease prevalance is significantly higher in those diagnosed wi…	Nutraceutical	Preclinical	Emerging	0	No indexed hits View evidence CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
Paeoniflorin Natural product Human Study An adverse immune reaction to wheat proteins is more commonly apparent… Human Study Cardamonin is a potential candidate for controlling inflammation during… Human Study Celiac disease prevalance is significantly higher in those diagnosed wi…	Nutraceutical	Preclinical	Emerging	0	18 pubs View evidence CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
Essential Fatty Acids Natural product Randomized controlled trial Systemic omega-6 essential fatty acid treatment and pge1 tear content i… Randomized controlled trial Patients with primary Sjögren's syndrome treated for two months with ev… Human Study Data support pro- and anti-inflammatory roles within EFA metabolism	Nutraceutical	Preclinical	Emerging	0	2 RCT View evidence Published literature Randomized controlled trial Systemic omega-6 essential fatty acid treatment and pge1 tear content in Sjögren's syndrome patients (Investigative ophthalmology & visual science, 2005) Randomized controlled trial Patients with primary Sjögren's syndrome treated for two months with evening primrose oil (Scandinavian journal of rheumatology, 1986) CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
Colostrum Natural product Human Study Bovine Colostrum has beneficial effects in Sjogren's syndrome and…	Nutraceutical	Preclinical	Emerging	0	3 pubs View evidence CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
Cardamonin Natural product Clinical trial publication Cardamonin inhibits pro-inflammatory cytokine production and suppresses… Human Study An adverse immune reaction to wheat proteins is more commonly apparent… Human Study Celiac disease prevalance is significantly higher in those diagnosed wi…	Nutraceutical	Preclinical	Emerging	0	1 Trial pubs View evidence Published literature Clinical trial publication Cardamonin inhibits pro-inflammatory cytokine production and suppresses NO pathway in PBMCs from patients with primary Sjögren's syndrome (Immunopharmacology and immunotoxicology, 2018) CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
Dhea (Dehydroepiandrosterone) Natural product Human Study An adverse immune reaction to wheat proteins is more commonly apparent… Human Study Cardamonin is a potential candidate for controlling inflammation during… Human Study Celiac disease prevalance is significantly higher in those diagnosed wi…	Nutraceutical	Approved	Emerging	0	2 trials View evidence Registry trials NCT00543166 — Sex Steroids in Sjögren's Syndrome: Effect of Substitution Treatment on Fatigue (UNKNOWN) PHASE4 NCT00391924 — Dehydroepiandrosterone Administration in Women With Systemic Lupus Erythematosus or Primary Sjögren's Syndrome (COMPLETED) PHASE2 CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
Pycnogenol (Pine Bark) Natural product Human Study Pycnogenol supplementation in patients with Sjogren syndromein a remiss… Human Study Supplementation with Pycnogenol® may offer advantages and management po…	Nutraceutical	Preclinical	Emerging	0	No indexed hits View evidence CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
Flavonoids Natural product Human Study Supplementation with Pycnogenol® may offer advantages and management po…	Nutraceutical	Preclinical	Emerging	0	3 pubs View evidence CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
Verbascoside Natural product Animal Study Acteoside promotes B cell-derived IL-10 production and ameliorates auto…	Nutraceutical	Preclinical	Emerging	0	No indexed hits View evidence CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
Blueberry Natural product Animal Study Blueberry stem extract prevents lacrimal hyposecretion.	Nutraceutical	Preclinical	Emerging	0	2 pubs View evidence CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
Goji Natural product Human Study An adverse immune reaction to wheat proteins is more commonly apparent… Human Study Cardamonin is a potential candidate for controlling inflammation during… Human Study Celiac disease prevalance is significantly higher in those diagnosed wi…	Nutraceutical	Preclinical	Emerging	0	1 pubs View evidence CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo
Isoflavones Natural product In Vitro Study Calycosin synergizes with methotrexate in the treatment of Sjögren&#039…	Nutraceutical	Preclinical	Emerging	0	No indexed hits View evidence CT.gov search · Cochrane · PubMed	GreenMedInfo	GreenMedInfo

Alterations and therapeutics are aggregated from public databases (Open Targets, HPO, ChEMBL, DGIdb, and others). Natural agents are candidates from OSMF narrative reviews on opensourcemed.info/chronic-disease.html — not approved treatments. This page is for research orientation only — not medical advice.

Disease overview

Remission & chronicity

Alterations

Therapeutics

Natural Products

Part of the Open Source Medicine Foundation Network