[Evidence-based therapy of systemic sclerosis].

Abstract

For the treatment of different forms of systemic sclerosis (SSc), drugs play a predominant role. Depending on disease activity as well as type and severity of cutaneous, vascular and internal organ manifestations, different systemic (antiinflammatory, immunosuppressive, antifibrotic) or organ-specific therapies are used. The scientific basis of most treatment modalities is insufficient and incomplete. There is sufficient evidence for an antiinflammatory and antiproliferative efficacy of glucocorticosteroids, methotrexate, cyclophosphamide and cyclosporine A in the treatment of diffuse cutaneous systemic sclerosis. Vasoactive therapies play an important role in treating Raynaud's phenomenon (nifedipine or other dihydropyridines, prostaglandin analogs, losartan, prazosine), and arterial (ACE blockers, AT-1 antagonists) or pulmonary (epoprostenol) hypertension. Cyclophosphamide is effective in fibrosing alveolitis, prokinetic substances (metoclopramid, domperidone) in gastroesophageal dysmotility or octreotide in intestinal pseudoobstruction. Physical therapies (e.g., massage) are poorly studied. In particular cases, surgical measures (e.g., removal of calcifications) are necessary.

• Authors: E Genth
• Journal: Zeitschrift fur Rheumatologie (Z Rheumatol) Vol. 60 Issue 6 Pg. 464-8 (Dec 2001) ISSN: 0340-1855 [Print] Germany
• Vernacular Title: Evidenz-basierte Therapie der systemischen Sklerose.
• PMID: 11826742 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• Antirheumatic Agents
• Glucocorticoids
• Immunosuppressive Agents

Topics

• Antirheumatic Agents (therapeutic use)
• Clinical Trials as Topic
• Evidence-Based Medicine
• Glucocorticoids (therapeutic use)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Scleroderma, Systemic (drug therapy)
• Treatment Outcome