Safety and efficacy of currently used drug therapies for treatment of lymphomas in patients with Sjögren's disease, a scoping review.

INTRODUCTION

Sjögren's disease (SjD) carries an increased risk of B-cell lymphoma, yet drug treatment strategies are largely extrapolated from general lymphoma care. This study summarizes available evidence on the efficacy and safety of drug therapies in SjD-associated lymphomas.

AREAS COVERED: A PubMed and Embase search (January 1995-August 2025) identified studies evaluating the efficacy and safety of pharmacologic treatment for SjD-associated non-Hodgkin B-cell lymphomas (English language, ≥5 patients). Rituximab (anti-CD20) monotherapy achieved reliable early disease control in localized, low-burden lymphoma with limited toxicity. In more disseminated or aggressive lymphoma types, particularly diffuse large B-cell lymphoma, immunochemotherapy (rituximab plus chemotherapy) remains standard. In indolent disease, immunochemotherapy combination regimens can improve lymphoma control. However, regimen-specific safety data are limited and inconsistently reported.

EXPERT OPINION: Current evidence supports a pragmatic, individualized approach. Rituximab remains the foundation of SjD-associated lymphoma therapy, typically combined with chemotherapy. However, current evidence is limited by small, heterogeneous cohorts, with pooled reporting across lymphoma types/regimens and limited safety reporting. Prospective SjD-specific studies, with regimen-level reporting of efficacy and safety are needed. Uniform endpoints that capture both hematologic and autoimmune activity, and lymphoma-type stratification should be applied.