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[Treatment of scleroderma].

Luc Mouthon1

  • 1Service de médecine interne Hôpital Avicenne (AP-HP), Université Paris XIII 93009 Bobigny. luc.mouthon@avc.ap-hop-paris.fr

La Revue Du Praticien
|January 21, 2003
PubMed
Summary

Currently, no single drug improves survival in systemic scleroderma patients. Emerging treatments like cyclophosphamide and stem cell transplants show promise for specific complications, alongside organ-targeted therapies.

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Area of Science:

  • Rheumatology
  • Immunology
  • Pulmonology

Context:

  • Systemic scleroderma (SSc) presents significant therapeutic challenges with no universally effective survival-enhancing treatments.
  • Traditional agents like colchicine and D-penicillamine have yielded disappointing results in clinical trials.
  • The disease often involves multiple organ systems, necessitating diverse treatment strategies.

Purpose:

  • To review the current landscape of systemic scleroderma therapeutics.
  • To highlight emerging disease-modifying and organ-specific treatment approaches.
  • To discuss the limitations of existing therapies and the potential of novel interventions.

Summary:

  • Prospective randomized trials have not identified a single agent that increases survival in systemic scleroderma.
  • Disease-modifying agents like cyclophosphamide for interstitial pulmonary disease and autologous stem cell transplantation for early visceral involvement are under investigation.
  • Organ-specific therapies, including ACE inhibitors for renal crisis and epoprostenol for pulmonary hypertension, offer significant benefits.

Impact:

  • This review underscores the need for more effective systemic scleroderma treatments.
  • It identifies promising avenues for future research and clinical application.
  • Highlights the importance of tailored, organ-specific management in improving patient outcomes.

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