Prevention Of Vascular Damage In Scleroderma With Angiotensin-converting Enzyme (ACE) Inhibition PDF Print E-mail
Monday, 27 December 2010 17:21
Great strides have been made in identifying and managing the organ-based complications of  systemic sclerosis (SSc). There is no room for the nihilism towards treating this disease that used to be so prevalent. However, there is still relatively little hard evidence on which to base treatment decisions. Previous trials have been constrained by the low disease prevalence and the difficulty in recruiting sufficient patients especially with disease of recent onset. The results of past trials have often been confounded by the failure to recognize the marked heterogeneity of SSc and the inclusion of patient subsets with widely varying disease expression, course and outcome. It is recognized that progress will only be made in this area with coordinated multicentre studies. As a result, national and international networks of clinicians with expertise in the management of SSc have been formed. In the UK, the Systemic Sclerosis Study Group has established a national scleroderma register and, together with the Scleroderma Special Interest Group of the British Society for Rheumatology (BSR), a multicentre base for therapeutic studies.

As a result of developments in our understanding of the pathogenesis of scleroderma and our ability to subset patients more effectively, a number of rather more rational approaches to treating the disease and its complications are being tested. In parallel with this, considerable progress is being made in developing universally agreed measures of disease activity and severity and in identifying surrogate laboratory markers of disease activity that are relevant to therapeutic studies. These multicentre trials need substantial funding and often do not attract support from the pharmaceutical industry. It was because of the difficulty in financing long-term, multicentre studies in uncommon conditions that the ARCuBSR Clinical Trials Programme was established. The QUINS trial, which is funded by this Programme, is described here as an example of one of several therapeutic protocols being developed by the UK Systemic Sclerosis Study Group that are currently being tested in multicentre trials. Contact details are provided in the appendix for clinicians who are interested in registering patients on the UK Scleroderma Register or participating in this or in the other therapeutic studies.

Login to download your own copy of the full and original article from the link provided below

 
More articles :

» PUVA Therapy In The Treatment of Localized Scleroderma

In localized , disease activity would tend to stop spontaneously over time. Treatment is important to reduce disabilities caused by the active phases of disease. According to , there are three treatments used in the treatment of localized...

» Toll-like receptor 7 (TLR7)–Driven Accumulation of a Novel CD11c+ B-cell Population is Important for the Development of Autoimmunity

Anatoly V. Rubtsov, Kira Rubtsova, Aryeh Fischer, Richard T. Meehan, Joann Z. Gillis, John W. Kapple, and Philippa MarrackThe American Society of HematologyFemales are more susceptible than males to many autoimmune diseases. The processes causing...

» How To Know If Your Body Is Acidic?

It can be really crucial to remember that the are normally based on the quantity of acids we have in our body. These signs and symptoms are grouped according to it order of severity. Much less severe symptoms may well indicate that you simply are...

» We Need Your Help!

Today, the Scleroderma Care Foundation embarks upon a mission of vital importance, and we are counting on your help. One of our dearest patients and friend, , is on the verge of Renal or and we are seeking out a qualified kidney donor. Currently,...

» Long-Term Outcomes of Scleroderma Renal Crisis

Virginia D. Steen, MD, and Thomas A. Medsger Jr., MDPublished: October 17th, 2000

» Nutrition Is Key To Combatting Your Autoimmune Disease

Every day, your protects you by attacking invaders such as bacteria and viruses. But when something goes awry with the body's immune system, immune cells may attack and damage tissues they were designed to protect, resulting in an autoimmune...