This article is part of the supplement: Advances in systemic sclerosis and related fibrotic and vascular conditions
Clinical trials in systemic sclerosis: lessons learned and outcomes
1 Division of Medicine and Surgery, Division of Medicine I and Rheumatology, Villa Monna Tessa, Viale Pieraccini, I-50139 Florence, Italy
2 Division of Rheumatology, Immunology and Allergy, Georgetown University Hospital, Reservoir Road NW, Washington, District of Columbia 20007, USA
3 David Geffen School of Medicine at UCLA, Veteran Ave, Los Angeles, California 90085-1670, USA
4 University of Michigan Scleroderma Program, East Medical Center Drive, Ann Arbor, Michigan 48109-0358, USA
Arthritis Research & Therapy 2007, 9(Suppl 2):S7 doi:10.1186/ar2191Published: 15 August 2007
The pathogenesis of systemic sclerosis (SSc) is complex and largely unclear. The clinical heterogeneity of the disease and its progression over a number of years makes the choice of endpoints in the design of clinical trials difficult. The overwhelming need in this disease is to diagnose it early and identify those patients who will benefit most from early, aggressive treatment that potentially can alter the clinical disease course. To achieve this, innumerable challenges must be overcome. This article reviews data from recent clinical trials and the lessons derived from retrospective observational studies, databases, and patient registries. Taken together, these observations will help to improve our understanding of the diverse clinical course of SSc and permit refinement of existing outcome measures for the design of future clinical trials, in which the likelihood of observing a positive treatment effect with the drugs at our disposal will be maximized.