Biologic therapy for systemic sclerosis: a systematic review

Area of Science:

• Rheumatology
• Immunology
• Pharmacology

Background:

• Biologic agents are increasingly utilized in rheumatic diseases.
• The efficacy and safety of biologics in systemic sclerosis (SSc) remain uncertain.
• Evidence is needed to guide the use of biologics in SSc management.

Purpose of the Study:

• To evaluate the effectiveness of biologic agents in improving inflammatory arthritis, disability, and skin score in SSc patients.
• To review the safety and adverse effects associated with biologic agent use in SSc.
• To synthesize current evidence on biologic therapies for systemic sclerosis.

Main Methods:

• A systematic literature review was conducted.
• Searches were performed across major databases including Medline, Embase, CINAHL, and Cochrane.
• Data on biologic agent, study design, sample size, treatment effects, and adverse events were extracted.

Main Results:

• Twenty-three studies involving various biologic agents were evaluated.
• Etanercept and infliximab showed potential improvements in inflammatory arthritis and disability (HAQ-DI).
• Other agents did not demonstrate reproducible, statistically significant benefits in joint count, HAQ-DI, or skin score.

Conclusions:

• Anti-tumor necrosis factor-α agents may offer benefits for inflammatory arthritis and disability in SSc.
• The impact of biologics on skin score in SSc is uncertain.
• Larger, adequately powered trials are necessary to confirm efficacy and assess long-term safety.