**8. Conclusions**

pSS is a multifaceted disease combining pleiomorphic systemic autoimmune manifestations, glandular manifestations, a frequently added psychosomatic component and the possible progression to non-Hodgkin lymphoma. Its management has two complementary facets: improving the quality of life of patients by tackling dryness, fatigue and chronic pain symptomatically in a multidisciplinary way and treating systemic manifestations to prevent damage, which will worsen the vital and functional prognosis. Although we understand more and more its pathophysiology, many questions remain unanswered, and its treatment remains disappointing compared to other autoimmune diseases. pSS therefore remains a vast field of investigation where much fundamental and clinical research remains to be done. Ten take-home messages:


corticosteroid therapy, combined or not with a broad-spectrum immunosuppressant. Rituximab will only be used as a third line, except in cases of cryoglobulinemia where it is the treatment of choice.

10. Despite targeted therapies having revolutionized rheumatology in recent years and the impressive number of molecules tested so far in pSS, a revolution like the one known in the field of RA has not yet occurred.

**Author Contributions:** D.P., C.C., J.P., M.S.S. and C.D. contributed to the writing of the review. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research was funded the EU H2020 contract HarmonicSS (H2020-SC1-2016-RTD/731944), Fonds Erasme, Fonds de la Recherche Scientifique—FNRS (grant J.0053.20). DP is a Research Fellow of the Fonds de la Recherche Scientifique—FNRS.

**Acknowledgments:** The authors thank Bahija Jellouli for her secretarial help.

**Conflicts of Interest:** The authors declare no conflicts of interest.
