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Treatment of scleroderma: an update
Sangeeta D Sule1, Fredrick M Wigley
1Division of Rheumatology, Johns Hopkins University, Baltimore, MD 21205, USA.
Expert Opinion on Investigational Drugs
|February 28, 2003
Summary
Novel therapies for scleroderma target vascular disease, autoimmunity, and fibrosis. Personalized treatment based on subtype, disease activity, and organ involvement is crucial for effective drug intervention and clinical trials.
Area of Science:
- Rheumatology
- Immunology
- Pulmonology
Background:
- Scleroderma management requires updated therapeutic strategies.
- Drug interventions should address key pathological processes: vascular disease, autoimmunity, and fibrosis.
Purpose of the Study:
- To review novel therapies and clinical trials in scleroderma published since the last review.
- To guide treatment decisions by emphasizing disease classification and activity assessment.
Main Methods:
- Literature review focusing on recent publications regarding scleroderma therapies and clinical trials.
- Analysis of evidence supporting interventions targeting vascular disease, autoimmunity, and fibrosis.
Main Results:
- Cyclophosphamide shows benefit in fibrosing alveolitis.
- Intravenous prostaglandins and vasodilators are beneficial for vascular disease.
- Endothelin-1 inhibition is promising for pulmonary hypertension.
- Immunosuppressive therapy is effective for early inflammatory disease.
- Agents like anti-transforming growth factor-beta, statins, and anti-integrins show promise in preclinical models.
Conclusions:
- Personalized treatment strategies are essential for scleroderma.
- Further well-designed clinical trials are needed to establish the efficacy of emerging therapies.