We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Is immunosuppressive therapy the anchor treatment to achieve remission in systemic sclerosis?
- Authors
Cappelli, Susanna; Bellando-Randone, Silvia; Guiducci, Serena; Matucci-Cerinic, Marco
- Abstract
Since activation of the immune system and a perivascular infiltrate of inflammatory cells are key features of SSc, immunosuppression has long been considered to be an anchor treatment. Non-selective immunosuppression remains central to the treatment of interstitial lung disease (ILD) and skin involvement, with CYC most widely used to obtain remission. The use of MTX as a first-line agent may be considered in the presence of skin involvement without ILD. More recently, MMF has shown encouraging results in observational studies, but still needs more formal evaluation to verify if it can be considered an alternative drug to CYC or a maintenance agent such as AZA. Rituximab has provided promising results in small open-label studies and other novel therapies targeting specific molecular and cellular targets are under evaluation. Patients with rapidly progressing diffuse cutaneous SSc should be evaluated for haematopoietic stem cell transplantation.
- Subjects
METHOTREXATE; RITUXIMAB; CYCLOPHOSPHAMIDE; MYCOPHENOLIC acid; AZATHIOPRINE; DATABASES; HEMATOPOIETIC stem cell transplantation; IMMUNOSUPPRESSIVE agents; META-analysis; HEALTH outcome assessment; SYSTEMIC scleroderma; SYSTEMATIC reviews; TREATMENT effectiveness; DISEASE remission; THERAPEUTICS
- Publication
Rheumatology, 2014, Vol 53, Issue 6, p975
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/ket312