Decoding Sjogren’s Disease: A Clinical Deep Dive – Season 2

Health Monitor Network

Building on an award-winning first season, Decoding Sjogren’s Disease: Season 2 answers the tough question: What happens after diagnosis? Phenotyping, biomarker surveillance, biologic candidacy, treatment timing — most clinicians are still making decisions with scores that were never built to guide treatment. Over five new episodes, the world’s leading Sjogren’s experts offer a masterclass on the mechanistic drivers, tracking tools, and precision medicine strategies defining the next era of Sjogren’s therapy. The standard of care for this disease is about to meaningfully shift. Is your practice keeping up? This content is intended for medical professionals only.

Episodes

  1. Aug 26

    Mechanistic Drivers of Sjogren’s

    Sjogren's has long been reduced to its most visible symptoms, but the biology tells a more complex story. In this episode, Dr. Nancy Carteron walks through the immune mechanisms driving Sjogren's from the inside out, including the interplay between Type I interferon signaling and B-cell hyperactivity, how germinal center structures in the salivary glands fuel ongoing autoimmunity, and why BAFF dysregulation may be a critical and underappreciated therapeutic target. Nancy also addresses the systemic reach of the disease into the lungs, nervous system, and beyond, and explains why a handful of routine lab values can help clinicians connect the dots earlier. About Dr. Nancy Carteron Dr. Carteron is a Professor at the University of California, Berkeley, and the immediate past chair of the Medical and Scientific Advisory group of the Sjogren’s Foundation. She currently sees patients at the Interdisciplinary Sjogren’s Clinic at UC Berkeley. She is a nationally recognized leader in clinical innovation and research for Sjogren’s disease. In this episode, we explore: (00:00) Connecting routine lab values to systemic Sjögren's disease (02:00) Why Sjögren's is no longer understood as a glandular condition (02:34) B-cell hyperactivity and where drug targets are strongest (03:29) Type I interferon as a loop, not a linear trigger (05:04) Germinal centers: drivers of autoimmunity or markers of established disease (06:54) BAFF dysregulation and why blocking it improves clinical outcomes (08:23) Tolerance checkpoint failures and what cancer immunotherapy is teaching us (10:11) Lung involvement and lymphocyte infiltration beyond the salivary glands (11:22) Ro52 and Ro60 as distinct antibodies with distinct phenotypic implications (12:44) Neurologic manifestations including ganglionopathy and what clinicians miss (14:22) If you take one thing from this episode... Learn more about your ad choices. Visit podcastchoices.com/adchoices

    Mechanistic Drivers of Sjogren’s

  2. Aug 26

    How to Track Disease Progression

    In this episode, Dr. Teja Kapoor unpacks why a single disease activity score tells only half the story, how to phenotype patients into actionable clinical categories, and which biomarkers should be on your radar before symptoms ever surface. If you rely on uniform monitoring schedules, this conversation will change how you think about follow-up. About Dr. Teja Kapoor Dr. Kapoor is the Director of the Columbia Sjögren’s Center and a leading advocate for earlier recognition and systemic management of Sjögren’s disease. In this episode, we explore: (00:00) Why SDI and ESSPRI correlate so poorly and what that reveals about Sjögren's disease (02:02) How the EULAR SDI is scored and where it falls short in routine practice (05:11) What SDI cannot capture: damage, flare trajectory, and symptom burden (06:53) Autonomic dysfunction in Sjögren's and how to screen for it using COMPASS-31 (09:05) The three recurring patient phenotypes and how to tailor surveillance to each (12:33) Triggers for escalating workup in the quiet, biologically active patient (14:23) Tiered biomarker monitoring: what to track in all patients versus high-risk subsets (16:14) Disease progression patterns: stepwise organ accumulation and biomarker-first signals (17:43) Salivary gland ultrasound as a longitudinal monitoring tool and what changes management (19:31) Distinguishing active Sjögren's from fibromyalgia and depression-driven symptom amplification (21:20) Early markers that predict systemic multi-organ progression versus glandular-limited disease (23:01) Gaps in current monitoring tools and what the field still needs (24:25) If you take one thing from this episode… Learn more about your ad choices. Visit podcastchoices.com/adchoices

    How to Track Disease Progression

  3. Aug 26

    Patient Classification and Treatment Goals

    When the disease is active but the patient feels fine, or the symptoms are overwhelming but the labs look quiet, standard protocols start to break down. This episode gets concrete about what precision Sjögren's care actually looks like at the bedside. Dr. Teja Kapoor walks through how to translate EULAR disease activity thresholds into individual treatment goals, when the case for off-label biologic therapy genuinely builds, and why seronegative patients with high symptom burden deserve a more systematic neurological and autonomic workup than most are currently receiving. About Dr. Teja Kapoor Dr. Kapoor is the Director of the Columbia Sjögren’s Center and a leading advocate for earlier recognition and systemic management of Sjögren’s disease. In this episode, we explore: (00:00) Separating the quiet biomarker patient from the quiet symptom patient (02:12) Translating EULAR disease activity thresholds into individual treatment goals (03:34) When off-label B-cell therapy becomes the right call (05:20) How the clinical trial pipeline is shifting the threshold for biologic intervention (07:05) Weighing organ-threatening domains against more common but less dramatic disease (08:39) Biologic candidacy in seronegative patients with high symptom and autonomic burden (11:29) What RF, ANA, and complement levels actually tell you about lymphoma risk (15:00) How to talk to patients about treating disease they cannot feel (16:11) Early gland-specific antibodies: promising concept, complicated evidence (18:21) If you take one thing from this episode... Learn more about your ad choices. Visit podcastchoices.com/adchoices

    Patient Classification and Treatment Goals

  4. Aug 26

    Biologic Therapy: Timing is Critical

    In this episode, Dr. Chadwick Johr of the Penn Sjögren Center walks through how he evaluates organ involvement, B-cell activity, and lymphoma risk to decide when to escalate treatment. He also unpacks why early anti-CD20 trials appeared to fail, what composite endpoints like CRESS revealed, and why the next wave of targeted therapies has him genuinely optimistic about the future of Sjögren's care. About Dr. Chadwick Johr Dr. Johr is the Director of the Penn Sjögren’s Center and an Associate Professor of Clinical Medicine at the University of Pennsylvania Perelman School of Medicine. His work focuses on comprehensive, team-based care for patients with complex autoimmune presentations. In this episode, we explore: (00:00) When organ involvement and B-cell activity drive the decision to prescribe biologics (05:21) Ultrasound changes in parotid glands before and after biologic treatment (07:51) Why anti-CD20 trials failed and what CRESS revealed when applied to the same data (09:45) Mechanisms drawing the most attention in the Sjögren's pipeline (10:32) Thirteen types of fatigue and why it remains the hardest symptom to treat (11:50) Insurance barriers, IVIG costs, and Medicare restrictions in practice (13:14) If you take one thing from this episode... Learn more about your ad choices. Visit podcastchoices.com/adchoices

    Biologic Therapy: Timing is Critical

  5. Aug 26

    The Promise of Precision Medicine

    Dr. Chadwick Johr, Director of the Penn Sjogren Center, cuts through the hype around precision medicine to assess where the field actually stands and what it will take to move from research protocols into real clinical decisions. He unpacks why Sjogren's resists a one-size-fits-all treatment approach, how salivary gland biopsy and interferon signatures are beginning to stratify patients in meaningful ways, and what the next decade could realistically deliver for both specialist centers and community rheumatology practices. About Dr. Chadwick Johr Dr. Johr is the Director of the Penn Sjögren’s Center and an Associate Professor of Clinical Medicine at the University of Pennsylvania Perelman School of Medicine. His work focuses on comprehensive, team-based care for patients with complex autoimmune presentations. In this episode, we explore: (00:00) Why precision medicine in Sjogren's is still in its early innings (02:47) Molecular endotypes and what they mean for treatment matching (03:30) Salivary gland biopsy as a diagnostic and prognostic tool (05:17) Interferon high versus low signatures and their clinical implications (06:41) Lymphoma risk concentrated in high interferon patient subgroups (07:27) What a better disease activity tool would need to include (08:20) How Sjogren's care will evolve across specialist and community settings (10:18) If you take one thing from this episode... Learn more about your ad choices. Visit podcastchoices.com/adchoices

    The Promise of Precision Medicine
  • 5 Episodes

About

Building on an award-winning first season, Decoding Sjogren’s Disease: Season 2 answers the tough question: What happens after diagnosis? Phenotyping, biomarker surveillance, biologic candidacy, treatment timing — most clinicians are still making decisions with scores that were never built to guide treatment. Over five new episodes, the world’s leading Sjogren’s experts offer a masterclass on the mechanistic drivers, tracking tools, and precision medicine strategies defining the next era of Sjogren’s therapy. The standard of care for this disease is about to meaningfully shift. Is your practice keeping up? This content is intended for medical professionals only.

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