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Inclusion Criteria:

Both cohorts must have met all the following criteria:

1. Signed informed consent must be obtained prior to participation in the study
2. Male or female patient \>= 18 years of age
3. Classification of Sjögren's Syndrome according to ACR/EULAR 2016 criteria (Shiboski et al 2016)
4. Seropositive for anti-Ro/SSA antibodies
5. Stimulated whole salivary flow rate of \>= 0.1 mL/min
6. Able to communicate well with the Investigator to understand and comply with the requirements of the study

   Inclusion criteria specific for Cohort 1:
7. Screening ESSDAI value \>= 5 within the following 8 organ domains: constitutional, lymphadenopathy, glandular, articular, cutaneous, renal, hematologic and biologic

   * Patients with involvement of one or more of the remaining 4 domains are eligible but scores of these domains will not contribute to the assessment for eligibility for Cohort 1
   * At selected sites participating in Cohort 2, patients who based on the above criterion 7, do not qualify for Cohort 1, should be further evaluated for Cohort 2
8. Screening ESSPRI score of \>= 5

   Inclusion criteria specific for Cohort 2:
9. Screening ESSDAI value \< 5 within 8 domains scored for inclusion criterion #7 Cohort 1
10. Screening ESSPRI fatigue subscore \>= 5 or ESSPRI dryness subscore \>= 5
11. Hypergammaglobulinemia defined by IgG greater than upper limit of normal (ULN) or lymphocytopenia (less than lower limit of normal (LLN)) or hypocomplementemia (low C3, or low C4 - when considered due to disease activity and not due to genetic factors)
12. Score of \>= 30 on IDEEL symptom bother questionnaire at Screening

Exclusion Criteria:

1. Sjögren's Syndrome overlap syndromes where another autoimmune rheumatic disease constitutes the principal illness
2. Use of other investigational drugs within 5 half-lives of enrollment or within 30 days whichever is longer, or longer if required by local regulations
3. Prior treatment with any of the following within 6 months prior to randomization:

   * B-cell depletors (e.g. rituximab, ianalumab) unless CD19+ B cell count have returned to ≥ 50 cells/µL
   * abatacept
   * anti-tumor necrosis factor alpha monoclonal anti-body
   * intravenous/subcutaneous Ig; plasmapheresis; i.v. or oral cyclophosphamide
   * i.v. or oral cyclosporine A
   * any other immunosuppressants unless explicitly allowed in criterion #5
4. Use of steroids (predniso(lo)ne or equivalent corticosteroid) at dose \> 10 mg/day
5. Use of steroids and synthetic DMARDS at inconsistent dose and within 3 months prior to randomization

• Suwanee, Georgia, United States
• Indianapolis, Indiana, United States
• Baton Rouge, Louisiana, United States
• Baltimore, Maryland, United States
• Boston, Massachusetts, United States
• Mineola, New York, United States
• Philadelphia, Pennsylvania, United States
• Madison, Wisconsin, United States
• Buenos Aires, Argentina
• CABA, Argentina
• Nedlands, Western Australia, Australia
• Graz, Austria
• Vienna, Austria
• Vitória, Espírito Santo, Brazil
• Juiz de Fora, Minas Gerais, Brazil
• São Paulo, São Paulo, Brazil
• Toronto, Ontario, Canada
• Rimouski, Quebec, Canada
• Trois-Rivières, Quebec, Canada
• Valdivia, Los Ríos Region, Chile
• Santiago, RM, Chile
• Santiago, Santiago Metropolitan, Chile
• Santiago, Santiago Metropolitan, Chile
• Concepción, Chile
• Medellín, Antioquia, Colombia
• Barranquilla, Atlántico, Colombia
• Cali, Valle del Cauca Department, Colombia
• Brest, France
• Le Kremlin-Bicêtre, France
• Lille, France
• + 41 more on CT.gov