Systemic Sclerosis

An Update

Uwe-Frithjof Haustein, MD, PhD

Disclosures

Lab Med. 2011;42(9):562-572. 

In This Article

Immunosuppressive Agents

Cyclophosphamide and methotrexate[98] exert significant effects on skin thickness and lung function. Cyclophosphamide is particularly recommended in the treatment of interstitial lung fibrosis; methotrexate is the treatment of choice in patients with SSc/myositis or SSc/arthritis. Recently mycophenolate mofetil has shown positive effects. There is no clear evidence for the efficacy of glucocorticoids. Indeed, dosages more than 7.5 mg daily are associated with a higher risk of renal crisis.[99] Patients on glucocorticoids should be carefully monitored for blood pressure and renal function.

Rituximab, a monoclonal antibody against the CD20 transmembrane protein on B cells, could not improve skin thickness or reduce autoantibody titres despite B cell depletion.[100]

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