A Randomized, Double-blind 2-arm NEPTUNUS Extension Study to Assess the Long-term Safety and Efficacy of Ianalumab in Patients With Sjogrens Syndrome.

Inclusion Criteria:

1. Signed informed consent prior to participation in the extension study.

2. Participants must have participated in either one of the two NEPTUNUS core studies,CVAY736A2301 or CVAY736A2302, and must have completed the entire treatment up toWeek 48 without treatment discontinuation in core NEPTUNUS studies.

3. In the judgement of the Investigator, participants must be expected to clinicallybenefit from continued ianalumab therapy.

Exclusion Criteria:

1. Use of therapies excluded by the NEPTUNUS-1 and NEPTUNUS-2 study protocols (seeNEPTUNUS studies protocols exclusion criteria in Section 5.2 for details).

2. Plans for administration of live vaccines during the study period.

3. Pregnant or nursing (lactating) women, where pregnancy is defined as the state of afemale after conception and until the termination of gestation, confirmed by apositive human Chorionic Gonadotropin (hCG) laboratory test.

4. Women of child-bearing potential (WOCBP), defined as all women physiologicallycapable of becoming pregnant, unless they are using highly effective methods ofcontraception while taking study treatment during dosing and for 6 months afterstopping of investigational drug. Highly effective contraception methods include:

• Total abstinence (when this is in line with the preferred and usual lifestyleof the participant. Periodic abstinence (e.g., calendar, ovulation,symptothermal, post-ovulation methods) and withdrawal are not acceptablemethods of contraception.

• Female bilateral tubal ligation, female sterilization (have had surgicalbilateral oophorectomy with or without hysterectomy) or total hysterectomy atleast six weeks before taking study treatment. In case of oophorectomy alone,only when the reproductive status of the woman has been confirmed by follow uphormone level assessment.

• Male sterilization (at least 6 months prior to screening). For femaleparticipants on the study, the vasectomized male partner should be the solepartner for that participant.

• Use of oral (estrogen and progesterone), injected, or implanted hormonalmethods of contraception or placement of an intrauterine device (IUD) orintrauterine system (IUS), or other forms of hormonal contraception that havecomparable efficacy (failure rate < 1%), for example hormone vaginal ring ortransdermal hormone contraception. In case of use of oral contraception women should have been stable on the same pillfor a minimum of 3 months before taking study treatment. Contraception should be used in accordance with locally approved prescribinginformation of concomitant medications administered. Women are considered post-menopausal if they have had 12 months of natural (spontaneous) amenorrhea with an appropriate clinical profile (e.g., age-appropriatehistory of vasomotor symptoms). Women are considered of not child-bearing potentialif they are post-menopausal or have had surgical bilateral oophorectomy (with orwithout hysterectomy), total hysterectomy or bilateral tubal ligation at least sixweeks ago. In the case of oophorectomy alone, only when the reproductive status ofthe woman has been confirmed by follow-up hormone level assessment is she considerednot of child-bearing potential. If local regulations deviate from the contraception methods listed above to preventpregnancy, local regulations apply and will be described in the informed consentform (ICF).

5. United States (and other countries, if male contraception is locally required):Sexually active males, unless they agree to use barrier protection duringintercourse with a woman of child-bearing potential, while taking study treatment.As condom use alone has a reported failure rate exceeding 1% per year, it isrecommended that female partners of male study participants use a second method ofbirth control. Although ianalumab is not teratogenic and/or genotoxic, and nottransferred to semen, male contraception is required, as requested by FDA.

Globally, for all sexually active males, contraception should be used in accordance with the locally approved prescribing information of concomitant medications administered.