Integrating palliative care principles into systemic sclerosis management

Systemic sclerosis (SSc) is a chronic multisystem autoimmune disease characterized by significant symptom burden, functional impairment, and reduced quality of life, even with advances in disease-directed therapies. This structured narrative review examines the potential role of integrating palliative care (PC) principles into multidisciplinary SSc management. A structured narrative review was conducted using literature identified in the PubMed/MEDLINE, Scopus, Web of Science, and DOAJ databases. Studies addressing supportive care, symptom management, rehabilitation, advance care planning (ACP), multidisciplinary care, and palliative-oriented interventions in SSc were reviewed and narratively synthesized. The available evidence suggests that palliative-oriented approaches may address unmet needs related to symptom burden, psychosocial distress, functional decline, and patient-centered outcomes in SSc. Interventions such as rehabilitation, hand and orofacial therapy, psychosocial support, nutritional management, pulmonary rehabilitation, and ACP, may improve quality of life and functional well-being when integrated with disease-directed treatment. However, most evidence is limited, heterogeneous, and primarily observational. The integration of PC principles into SSc management may serve as a valuable supportive strategy throughout the disease course, rather than being restricted to end-stage disease. Further prospective multidisciplinary studies are necessary to define optimal implementation strategies and patient-centered outcomes.