[Treatment of systemic sclerosis-associated interstitial lung disease].

Therapie der systemischen Sklerose-assoziierten interstitiellen Lungenerkrankung.

Journal

Zeitschrift fur Rheumatologie
ISSN: 1435-1250
Titre abrégé: Z Rheumatol
Pays: Germany
ID NLM: 0414162

Informations de publication

Date de publication:
Apr 2020
Historique:
pubmed: 23 11 2019
medline: 12 9 2020
entrez: 23 11 2019
Statut: ppublish

Résumé

Systemic sclerosis (SSc) is a fibrosing autoimmune disease of the connective tissue. In addition to skin fibrosis, pulmonary involvement and interstitial lung disease (ILD) in particular are the most common and severe manifestations of SSc. The disease is associated with a substantial risk of morbidity and mortality, especially in progressive ILD. In the last 5 years new treatment concepts for SSc-ILD have been investigated in numerous clinical studies. This review is based on a literature search in PubMed, focusing on the most relevant papers published up to the end of 2018 with the keywords "SSc" and "treatment". The treatment of SSc-ILD has changed over the last few years due to the results of many clinical studies. The updated guidelines of the European League Against Rheumatism (EULAR) recommend the use of cyclophosphamide or hematopoietic stem cell transplantation. Data for a positive influence on SSc-ILD are also available for mycophenolate, tocilizumab and anabasum. Because of the pathophysiological similarities to idiopathic pulmonary fibrosis, the use of the antifibrotic agents nintedanib and pirfenidone is currently being investigated in randomized, multicenter clinical trials and could be a novel and promising therapeutic strategy. Current drug studies may provide innovative therapeutic perspectives for SSc-ILD and could significantly improve the prognosis of affected patients in the future.

Sections du résumé

BACKGROUND BACKGROUND
Systemic sclerosis (SSc) is a fibrosing autoimmune disease of the connective tissue. In addition to skin fibrosis, pulmonary involvement and interstitial lung disease (ILD) in particular are the most common and severe manifestations of SSc. The disease is associated with a substantial risk of morbidity and mortality, especially in progressive ILD. In the last 5 years new treatment concepts for SSc-ILD have been investigated in numerous clinical studies.
MATERIAL AND METHODS METHODS
This review is based on a literature search in PubMed, focusing on the most relevant papers published up to the end of 2018 with the keywords "SSc" and "treatment".
RESULTS RESULTS
The treatment of SSc-ILD has changed over the last few years due to the results of many clinical studies. The updated guidelines of the European League Against Rheumatism (EULAR) recommend the use of cyclophosphamide or hematopoietic stem cell transplantation. Data for a positive influence on SSc-ILD are also available for mycophenolate, tocilizumab and anabasum. Because of the pathophysiological similarities to idiopathic pulmonary fibrosis, the use of the antifibrotic agents nintedanib and pirfenidone is currently being investigated in randomized, multicenter clinical trials and could be a novel and promising therapeutic strategy.
CONCLUSION CONCLUSIONS
Current drug studies may provide innovative therapeutic perspectives for SSc-ILD and could significantly improve the prognosis of affected patients in the future.

Identifiants

pubmed: 31754786
doi: 10.1007/s00393-019-00724-y
pii: 10.1007/s00393-019-00724-y
doi:

Substances chimiques

Immunosuppressive Agents 0
Cyclophosphamide 8N3DW7272P

Types de publication

Journal Article Review

Langues

ger

Sous-ensembles de citation

IM

Pagination

294-303

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Auteurs

A Prasse (A)

Klinik für Pneumologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland. Prasse.Antje@mh-hannover.de.

F Bonella (F)

Ruhrlandklinik, Klinik für Pneumologie, Universitätsmedizin Essen, Essen, Deutschland.

U Müller-Ladner (U)

Abteilung für Rheumatologie und Klinische Immunologie, Justus-Liebig-Universität Gießen, Campus Kerckhoff, Bad Nauheim, Deutschland.

T Witte (T)

Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Hannover, Deutschland.

N Hunzelmann (N)

Klinik und Poliklinik für Dermatologie und Venerologie, Uniklinik Köln, Köln, Deutschland.

J Distler (J)

Klinik für Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Erlangen, Deutschland.

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Classifications MeSH