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Related Experiment Videos

Treatment of generalized systemic sclerosis.

M A Torres1, D E Furst

  • 1University of Medicine and Dentistry, New Jersey, Robert Wood Johnson Medical School, New Brunswick.

Rheumatic Diseases Clinics of North America
|February 1, 1990
PubMed
Summary

Many systemic sclerosis (SSc) treatments initially showed promise but failed in controlled trials. Current evidence rules out n-acetylcysteine, colchicine, and others, while some therapies await further investigation.

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Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • Systemic sclerosis (SSc) treatment has historically seen numerous uncontrolled studies with promising initial results.
  • Controlled trials have often failed to corroborate these early findings, leading to re-evaluation of therapeutic efficacy.

Purpose of the Study:

  • To critically review existing evidence on SSc treatments.
  • To identify therapies that have been definitively disproven or require further rigorous investigation.

Main Methods:

  • Systematic review of uncontrolled and controlled studies on SSc therapies.
  • Analysis of data to determine the level of evidence for various treatment modalities.

Main Results:

  • Several treatments, including n-acetylcysteine, colchicine, chlorambucil, cyclofenil, and DMSO, are now considered ineffective for general SSc treatment, especially in longer-duration disease.
  • Ketanserin and prostaglandin infusions primarily benefit Raynaud's phenomenon, not SSc itself. Angiotensin-converting enzyme inhibitors are crucial for renal crises but do not alter the disease course.
  • Drugs like 5-fluorouracil, D-penicillamine, dipyridamole, and para-aminobenzoic acid have limited supportive data and require well-controlled trials.
  • Factor XIII, apheresis, gamma-interferon, photopheresis, and ketotifen show potential but need further validation through controlled studies.

Conclusions:

  • The efficacy of many SSc treatments remains uncertain, with some definitively ruled out based on current evidence.
  • Ongoing research into novel therapies and a deeper understanding of SSc pathogenesis at the cellular and genomic levels are crucial for future treatment advancements.

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