My two cents is steroids should be used only temporarily to provide short-acting relief while you wait for a longer acting drug, ie like a biologic, to kick in.

I have been on steroids for 6 years while I trialed different biologic drugs trying to find the right one - I now have steroid myopathy and adrenal insufficiency as the steroids have destroyed my type 2 muscle fibers and suppressed my adrenal function. So while I need to get off steroids - I can’t. So IMHO steroids should be used sparingly and never as the primary drug if at all possible.

I was denied IVIg this week under myopathy, but my doctor resubmitted under neuropathy and it is now approved. If you have Sjogrens with neuropathy and have had multiple primary failures, I believe IVIg can be used. Has your doctor appealed the denial?