• Diagnosis of rheumatoid arthritis meeting 2010 ACR/EULAR criteria with positive Rheumatoid Factor or Anti Citrullinated Protein Antibody
• High-sensitivity C-reactive protein > 3 mg/L or Erythrocyte Sedimentation Rate > 28 mm/hr
• Prior biologic disease modifying anti-rheumatic drug treatment for at least 12 weeks with refractory disease
• At least six swollen and six tender joints on assessment
• Confirmed primary Sj�f6gren's disease diagnosis within 24 weeks before screening per 2016 ACR/EULAR criteria
• European League Against Rheumatism Sjogren's Syndrome Disease Activity Index score above 6
• Salivary flow rate above 0.1 mL/min with stimulation
• Positive autoantibody (ANA >1:80 or RNP or SSA/SSB or other myositis specific autoantibodies) for idiopathic inflammatory myopathies
• Refractory idiopathic inflammatory myopathies with inadequate response or intolerance to at least 3 months of glucocorticoids and/or one other immunosuppressive
• Muscle biopsy or muscle MRI confirming diagnosis within 12 months before enrollment
• Systemic sclerosis diagnosis per ACR/EULAR 2013 classification with skin score above 10
• Confirmed systemic sclerosis diagnosis within 8 years before screening
• Refractory systemic sclerosis with inadequate response or intolerance to at least 3 months of glucocorticoids and/or one other immunosuppressive

History of severe allergic reactions to study medication Currently pregnant or breastfeeding Recent participation in another clinical trial within the last 30 days Presence of uncontrolled medical conditions that could affect safety