Cytokines and Fatigue in Sjogren's Syndrome: An Evolving Landscape.

We thank Chiche et al for their interest in our study. Sjogren's syndrome (SS) patients consistently report profound, debilitating fatigue as the single symptom which most severely decreases their quality of life. Although this information should inform drug development efforts, the voice of the patient has not been well represented in SS clinical trials. The primary endpoint in many of the clinical studies over the past decade have relied on the European Union Against Rheumatism (EULAR) Sjogren's Syndrome Disease Activity Index (ESSDAI), which does not measure fatigue or dryness, the chief complaints of these patients