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Systemic sclerosis: Recent insight in clinical management.

Elisabetta Zanatta1, Veronica Codullo1, Jérôme Avouac1

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Systemic sclerosis (SSc) is a complex fibrotic disease. Better patient stratification and new therapies targeting inflammation and fibrosis offer hope for improved outcomes in SSc management.

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Area of Science:

  • Rheumatology
  • Immunology
  • Fibrosis Research

Background:

  • Systemic sclerosis (SSc) is a connective tissue disease with microangiopathy, immune dysregulation, and fibrosis.
  • Current subclassification (limited/diffuse cutaneous) inadequately captures SSc phenotypes.
  • Disease course prediction and patient stratification remain significant challenges.

Purpose of the Study:

  • To review recent advancements in understanding SSc phenotypes and organ involvement.
  • To discuss emerging therapeutic strategies targeting SSc.
  • To highlight unmet needs in SSc patient management, particularly early identification of high-risk individuals.

Main Methods:

  • Review of recent preclinical studies and randomized controlled trials.
  • Analysis of cluster analysis-based studies for patient stratification.
  • Discussion of current and future therapeutic options, including combination therapies.

Main Results:

  • New drugs targeting inflammatory, immunological, and fibrotic pathways show encouraging results.
  • Improved diagnostic criteria (EULAR/ACR 2013) enhance sensitivity but not phenotypic capture.
  • Ongoing research aims for better SSc patient stratification for personalized treatment.

Conclusions:

  • Optimized patient stratification and novel therapies are crucial for improving SSc prognosis.
  • Early identification of high-mortality risk patients is a key unmet need.
  • Future research should focus on combination therapies for complex SSc management.