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8.1.2 Before initiating second-line immunosuppressive therapy, it is essential to exclude sub-optimal dosing, non-adherence, alternative etiologies, co-morbidities and autoimmune sclerosing cholangitis/overlap syndrome (LOE 5, Strong recommendation)

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both scores subsequently reached 0 by day 60, indicating remission

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An abnormally high level of IL-6 was detected in both saliva and serum in pSS patients [67]