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Precision Medicine Benefits Patients with Systemic Sclerosis

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One candidate prognostic biomarker for SSc-ILD is Krebs von den Lungen-6 (KL-6). KL-6 is a molecule that is predominantly expressed by damaged alveolar type II cells. In 2024, a study evaluated the prognostic potential of this circulating biomarker for FVC decline and change in modified Rodnan skin score (mRSS) over 52 weeks in the placebo group of the SENSCIS trial. In the 288 patients who received placebo, a baseline KL-6 ≥1000 U/mL was associated with lower median FVC% predicted and higher median mRSS than subjects with KL-6 <1000 U/mL. Additionally, higher baseline levels of KL-6 were associated with a greater rate of decline in FVC over 52 weeks.4

Dr. Volkmann’s hope is that studies like this one will help to identify and validate prognostic and predictive biomarkers for patients with SSc-ILD, enabling the highest risk patients to receive treatment early in their disease course.

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The session was excellent and indeed represented the best ideas in line with precision medicine. Patients with scleroderma, and SSc-ILD in particular, are still suffering from mortality rates that remain stubbornly high, thus, sessions such as this one are necessary to bend the curve and improve care for patients around the world

Jason Liebowitz, MD, is an assistant professor of medicine in the Division of Rheumatology at Columbia University Vagelos College of Physicians and Surgeons, New York.

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References

  1. Avouac J, Fransen J, Walker UA, et al. Preliminary criteria for the very early diagnosis of systemic sclerosis: Results of a Delphi Consensus Study from EULAR Scleroderma Trials and Research Group. Ann Rheum Dis. 2011 Mar;70(3):476–481.
  2. Steen V, Medsger TA Jr. Predictors of isolated pulmonary hypertension in patients with systemic sclerosis and limited cutaneous involvement. Arthritis Rheum. 2003 Feb;48(2):516–522.
  3. Ross RL, et al. Biosamples from VEDOSS patients show classic pathological signs of Scleroderma: Opportunity for a biological diagnosis of disease. Br J Rheumatol. 2023 April;62(2).
  4. Assassi S, Kuwana M, Ittrich C, et al. Prognostic value of circulating biomarkers in patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD). Ann Rheum Dis. 2024;83:332.

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