Disease-modifying treatment
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Treatments which modify the progression of systemic sclerosis may be classified into three groups:
- specific immunosuppressant therapy:
- cyclosporin A:
- good for skin but bad for kidneys
- antithymocyte globulin:
- good for skin
- plasmapheresis:
- anecdotal evidence only
- cyclosporin A:
- global immunosuppressant therapy:
- methotrexate
- corticosteroids
- alkylating agents e.g. azathioprine, cyclophosphamide
- ritixumab
- study suggest that rituximab treatment may provide long-term benefit for patients with systemic sclerosis, and serum immunoglobulins should be explored as potential response markers (1)
- study suggest that rituximab treatment may provide long-term benefit for patients with systemic sclerosis, and serum immunoglobulins should be explored as potential response markers (1)
- anti-fibrotic therapy:
- D-penicillamine:
- good for lung, skin and kidney
- interferons alpha & gamma:
- probably beneficial, but morbidity with interferons is significant
- D-penicillamine:
Reference:
- Kuzumi A, Ebata S, Fukasawa T, et al. Long-term Outcomes After Rituximab Treatment for Patients With Systemic Sclerosis: Follow-up of the DESIRES Trial With a Focus on Serum Immunoglobulin Levels. JAMA Dermatol. Published online February 15, 2023. doi:10.1001/jamadermatol.2022.6340
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