[Pharmacological inhibition of fibrosis exemplified by systemic sclerosis : Possibilities and limits]

Fibrotic diseases, such as cardiac, liver and lung fibrosis are a heterogeneous group of diseases with high mortality and fatality rates. Identifying cross-disease mechanisms is a potential strategy to find targets for these sometimes rare diseases. Additionally, it is necessary to consider disease-specific differences. Systemic sclerosis (SSc) is an autoimmune, fibrotic systemic disease. The possibilities and limitations of the pharmacological inhibition of fibrosis are exemplified and discussed in this article using SSc as an example. The focus of the article is on relevant pathogenetic aspects, new insights into known therapeutic principles, emerging developments "on the way to clinical application and ongoing studies", as well as an outlook on open questions. Continuing innovations in the field of molecular biological and computer-assisted analytical methods are enabling an increasingly more precise understanding of fibrosing tissue processes, serving as a basis for identifying new treatment strategies and approaches. Numerous targeted therapies are currently in phase 2/phase 3 clinical trials and are expected to be concluded in the coming years. Additionally, innovative options for deep B‑cell depletion are available for clinical testing; however, a "cure" for fibrotic diseases has not yet been achieved, and further questions remain on the research agenda.