Systemic sclerosis (SSc) is a multi-system connective tissue disease in which skin and internal organ fibrosis are associated with an obliterative micro-vasculopathy and a degree of inflammation.1 Patients often report it takes one to three years from the appearance of the first signs and symptoms before they receive a diagnosis. The signs and symptoms of…
Study Probes New Gene Therapy for Severe, Localized Scleroderma (Morphea)
In September 2018, the U.S. Food & Drug Administration (FDA) granted fast-track status to FCX‑013, a gene therapy product developed to treat moderate to severe localized scleroderma (morphea). Previously, the treatment received an orphan drug designation for localized scleroderma, as well as a rare pediatric disease designation. Phase 1 and 2 studies will assess safety…
New Studies Identify Possible Markers of Early Systemic Sclerosis
Although the true cause of systemic sclerosis (SSc), or scleroderma, remains unknown, researchers have made progress in detecting the autoimmune disease’s early presence. Beyond the physiological signs of Raynaud’s phenomenon, a capillaroscopy can detect alterations in microcirculation and lab tests can confirm the presence of telltale autoantibodies, such as anti-topoisomerase 1, anti-centromere and anti-RNA polymerase…
Lessons Learned from Two Scleroderma Lung Studies (Plus a Third That’s Recruiting Sites)
Historically, the early approach for treating interstitial lung disease (ILD) due to systemic sclerosis (SSc) involved immunosuppressant therapy, primarily with cytotoxic agents.1 Glucocorticoids in combination with another immunosuppressant agent, such as oral azathioprine or cyclophosphamide, were often used to treat patients with severe, progressive SSc-ILD.2 However, direct evidence to support this therapeutic approach was lacking…
Recent Trials Investigated Targeted Therapies for Systemic Sclerosis
SNOWMASS VILLAGE, COLO.—Data from three recent trials in systemic sclerosis (scleroderma) provide information on a number of important issues related to screening and treatment. First presented at the 2018 ACR/ARHP Annual Meeting, the phase 2/3 trials assessed the safety and efficacy of targeted agents to treat patients with systemic sclerosis.1-3 In a follow-up presentation at…
Markers for Severe Gastrointestinal Dysmotility in Systemic Sclerosis
A new study from Johns Hopkins University School of Medicine, published in the September 2018 issue of Arthritis Care & Research, identifies risk factors and clinical features associated with severe gastrointestinal (GI) dysmotility in patients with systemic sclerosis.1 The findings suggest a distinct pathological process may be at work in this patient group, says lead…
The Little-Known (But Not Uncommon) SSc-Lupus Overlap Syndrome
What happens when systemic sclerosis (SSc) overlaps with other systemic autoimmune rheumatic diseases? Patients with either diffuse cutaneous or limited cutaneous SSc sometimes develop systemic lupus erythematosus (SLE) as well. A new, large cohort study published in the Journal of Rheumatology reveals details on the epidemiology, clinical signs and survival data of SSc-SLE overlap syndrome.1…
A Case of Eosinophilic Fasciitis Presenting with Pansclerotic Morphea
Eosinophilic fasciitis generally presents with the acute onset of edema followed by progressive skin induration in the setting of hypergammaglobulinemia, an elevated erythrocyte sedimentation rate (ESR) and peripheral eosinophilia in 63–93% of patients.1,2 Skin involvement is typically limited to 20.1% of total body surface area and most commonly involves the extremities symmetrically.1,3 The condition was…
Living Well with Scleroderma
CHICAGO—Can non-drug interventions improve the lives of patients with scleroderma? Janet L. Poole, PhD, OTR/L, professor and director of the Occupational Therapy Graduate Program of the School of Medicine, University of New Mexico, Albuquerque, addressed this question when she presented the ARHP Distinguished Lecture at the 2018 ACR/ARHP Annual Meeting. She discussed the challenges faced…
Scleroderma Autoantibodies Linked to Cancer Risk
Recent studies point to a relationship between scleroderma and autoantibodies (e.g., anti-RNA polymerase III or anti-RNPC3), and an increased cancer risk within a short interval of scleroderma onset. Mechanistic studies provide further evidence that cancer may trigger scleroderma in patients with these autoantibodies. However, many questions remain unanswered. A study in the Annals of the…
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