New Lines of Treatment of Systemic Sclerosis

Abstract

A chronic autoimmune illness known as systemic sclerosis (SSc) has an extremely dismal prognosis. There are a number of SSc consequences, but so far, there is no cure for skin sclerosis, fibrotic lesions, or SSc-associated interstitial lung disease (SSc-ILD). However, randomized, placebo-controlled trials have shown that nintedanib, tocilizumab, and rituximab are effective and safe for SSc or SSc-ILD, respectively, since 2019. After the SENSCIS study indicated that nintedanib inhibited the loss in forced vital capacity (FVC), a measure of SSc-ILD, it was approved for use in all regions of the US, Europe, and Japan as an antifibrotic drug for SSc-ILD. Following evidence that the anti-interleukin-6 receptor antibody tocilizumab prevented a decline in FVC in the FocuSSced trial, the drug was authorized for the treatment of SSc-ILD in the US. Rituximab is an anti-CD20 antibody that was approved in Japan for the treatment of SSc after showing improvement in both FVC and the modified Rodnan skin score, a marker of skin sclerosis, in the DESIRES study. These three medications mark a turning point in the history of SSc treatment. Recent developments in SSc treatments, with an emphasis on nintedanib, tocilizumab, and rituximab, are detailed in this article.