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Treatment of systemic sclerosis
1University of Pittsburgh School of Medicine, Pennsylvania.
Current Opinion in Rheumatology
|December 1, 1991
Summary
Recent advancements show promise in managing systemic sclerosis, with new treatments targeting vascular, immune, and fibroblast pathways. Angiotensin-converting enzyme inhibitors dramatically improved renal crisis survival.
Area of Science:
- Rheumatology
- Immunology
- Vascular Medicine
Background:
- Systemic sclerosis management has seen renewed interest with recent clinical trials.
- Therapeutic strategies are targeting diverse pathogenic mechanisms of the disease.
Purpose of the Study:
- To review recent therapeutic developments in systemic sclerosis.
- To evaluate the efficacy of various treatments targeting different disease aspects.
Main Methods:
- Review of recent small series and double-blind, controlled trials.
- Analysis of treatments targeting vascular, immune, and fibroblast pathways.
- Assessment of outcomes for Raynaud's phenomenon, renal crisis, and visceral abnormalities.
Main Results:
- Positive effects on vascular aspects (Raynaud's phenomenon) observed with iloprost, thyroxine, and calcitonin.
- Mixed results for immune-mediated treatments; encouraging in small cohorts but not consistently effective in controlled studies.
- Angiotensin-converting enzyme inhibitors significantly improved survival in renal crisis.
- D-penicillamine and interferon gamma showed some success in altering fibroblast function.
Conclusions:
- Recent therapeutic research offers potential improvements in systemic sclerosis management.
- Targeted therapies for vascular and renal complications show particular promise.
- Further research is needed to optimize treatments for all manifestations of systemic sclerosis.