Use of biologics and other novel therapies for the treatment of systemic sclerosis

Expert Rev Clin Immunol. 2017 May;13(5):469-482. doi: 10.1080/1744666X.2017.1263153. Epub 2016 Dec 12.

Abstract

Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by vasculopathy, inflammation and fibrosis. These three main disease-determining pathways are the target of the currently available treatments used to possibly modify the progression of disease-related manifestations, although this synergy has not been fully applied on SSc joint, skin or lung involvement yet. Areas covered: we describe the current status of SSc treatment/therapy performing a literature search in MEDLINE/Pubmed and Thomson Reuter's Web of Science for articles published until March 2016. Moreover, ongoing registered clinical trials (RCTs) on SSc were searched through clinicaltrials.gov website. Expert commentary: presently, promising drugs are under evaluation to target the different pathogenic pathways of systemic sclerosis: Tocilizumab and Abatacept for skin and lung fibrosis; Riociguat and Selexipag are approved for pulmonary arterial hypertension but promising anti-fibrotic effects are now being studied. Finally, several anti-fibrotic molecules are currently involved in RCTs, such as Nintedanib, IVA-337, Terguride.

Keywords: Systemic sclerosis; biologics; fibrosis; immunity; inflammation; novel therapies; vasculopathy.

Publication types

  • Review

MeSH terms

  • Abatacept / therapeutic use
  • Acetamides / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Biological Products / therapeutic use*
  • Clinical Trials as Topic
  • Fibrinolytic Agents / therapeutic use*
  • Fibrosis
  • Humans
  • Hypertension, Pulmonary / drug therapy*
  • Indoles / therapeutic use
  • Inflammation
  • Joints / pathology*
  • Lisuride / analogs & derivatives
  • Lisuride / therapeutic use
  • Lung / pathology*
  • PubMed
  • Pyrazines / therapeutic use
  • Pyrazoles / therapeutic use
  • Pyrimidines / therapeutic use
  • Scleroderma, Systemic / drug therapy*
  • Skin / pathology*

Substances

  • Acetamides
  • Antibodies, Monoclonal, Humanized
  • Biological Products
  • Fibrinolytic Agents
  • Indoles
  • Pyrazines
  • Pyrazoles
  • Pyrimidines
  • dironyl
  • selexipag
  • Abatacept
  • Lisuride
  • nintedanib
  • tocilizumab
  • riociguat