Abstract
BACKGROUND: Sjögren's syndrome (SjS) is a chronic autoimmune disease characterized by exocrine gland dysfunction and systemic involvement. Although international guidelines exist, regional adaptations are necessary to address specific healthcare settings. In 2024, the Qazaq College of Rheumatology (QCR) developed comprehensive national recommendations for the diagnosis and management of SjS in Kazakhstan. METHODS: A panel of national experts reviewed and synthesized international guidelines (EULAR, ACR, and BSR) alongside local clinical data to create tailored diagnostic and therapeutic algorithms. Special emphasis was placed on the management of severe systemic manifestations and accessibility of therapies within Kazakhstan's healthcare system. RESULTS: The QCR recommendations propose a structured diagnostic approach combining clinical features, serological markers, and minor salivary gland biopsy. Treatment strategies emphasize non-pharmacological measures, symptomatic therapies, and immunomodulatory agents for systemic disease. Rituximab is prioritized as the first-line biologic for refractory severe extraglandular manifestations. A national registry for SjS is proposed to monitor implementation and outcomes. CONCLUSION: These guidelines aim to standardize the diagnosis and management of Sjögren's syndrome across Kazakhstan, improve patient outcomes, and support further research initiatives.