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 :

» 7 Tips For Maintaining Healthier Skin In Scleroderma

Scleroderma is a rare, connective tissue disease in which the body’s normal tissue is replaced with thick, dense tissue, due to the overproduction of collagen. Although can affect other parts of the body including the kidneys, hearts, and...

» Real-World Bosentan Therapy Successful in Pulmonary Arterial Hypertension: Presented at ATS

Real-life experiences in treating patients with pulmonary arterial hypertension with bosentan appears to provide similar efficacy as seen in clinical trials -- despite patients being somewhat older and having more scleroderma, researchers said today...

» Egr-1: A Target for Scleroderma Therapy

Two separate research groups funded by the (NIAMS) have discovered that the molecule EGR-1 (early growth response 1), which regulates gene expression, plays a central role in the development of fibrosis, a condition in which organ-supporting tissue...

» Juvenile Scleroderma Progression Similar To Adult Onset

The pattern and course of disease in patients who develop systemic sclerosis in childhood or adolescence is similar to that in patients who develop the disease as adults, data from Europe has shown.There were 60 patients among 5,000 included in the...

» The Clinical Relevance of Autoantibodies in Scleroderma

Khanh T Ho and John D ReveillePublished: 12 February 2003Arthritis Res Ther 2003, 5:80-93 (DOI 10.1186/ar628)© 2003 BioMed Central Ltd (Print ISSN 1478-6354; Online ISSN 1478-6362)Scleroderma (systemic sclerosis) is associated with several...

» African Americans Have More Severe Complications From Scleroderma

African Americans have more severe complications from systemic sclerosis, also known as scleroderma, than Caucasians. Findings published today in, , a journal of the American College of Rheumatology (ACR), show that compared with Caucasians,...