Abstract
Systemic sclerosis (SSc) is an autoimmune rheumatic disease with heterogeneous clinical manifestations and a variable course in which the severity of the pathology dictates the disease prognosis and course. Among autoimmune rheumatic diseases, SSc has the highest mortality rate among all rheumatic diseases, though there are exciting new therapeutic targets that appear to halt the progression of SSc manifestations such as skin or lung fibrosis. In selected patients, high-intensity regimens with autologous stem cell transplantation can favorably modify the course. In what was once thought to be an untreatable disease, targeted therapies have now changed the outlook of SSc to a treatable disorder. Herein, we discuss the targeted therapies modifying the outlook on selected organ involvement and creating opportunities for future treatment. We also present a framework for defining low disease activity in SSc.
© 2020, American College of Rheumatology.
Publication types
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Research Support, N.I.H., Extramural
MeSH terms
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Acute Disease
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Antihypertensive Agents / therapeutic use
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Disease Progression
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Endothelin Receptor Antagonists / therapeutic use
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Fibrosis
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Fingers
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Heart Diseases / etiology
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Heart Diseases / physiopathology
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Heart Diseases / therapy*
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Hematopoietic Stem Cell Transplantation
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Humans
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Immunosuppressive Agents / therapeutic use
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Kidney Diseases / etiology
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Kidney Diseases / physiopathology
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Kidney Diseases / therapy*
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Lung Diseases, Interstitial / etiology
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Lung Diseases, Interstitial / physiopathology
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Lung Diseases, Interstitial / therapy*
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Myocardium / pathology
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Outcome Assessment, Health Care
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Prostaglandins I / therapeutic use
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Pulmonary Arterial Hypertension / etiology
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Pulmonary Arterial Hypertension / physiopathology
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Pulmonary Arterial Hypertension / therapy*
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Raynaud Disease / etiology
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Raynaud Disease / physiopathology
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Raynaud Disease / therapy*
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Scleroderma, Systemic / complications
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Scleroderma, Systemic / physiopathology
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Scleroderma, Systemic / therapy*
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Severity of Illness Index
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Skin Ulcer / etiology
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Skin Ulcer / physiopathology
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Skin Ulcer / therapy*
Substances
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Antihypertensive Agents
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Endothelin Receptor Antagonists
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Immunosuppressive Agents
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Prostaglandins I