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Risikoadaptierte Therapien bei der systemischen Sklerose

Clinical risk-adapted therapies in systemic sclerosis

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Zusammenfassung

Die systemische Sklerose stellt eine große Herausforderung bezüglich der frühen Risikostratifizierung und den daraus abzuleitenden therapeutischen Konsequenzen dar. Ausgehend von einer Literaturanalyse und eigenen Erfahrungen an mehr als 450 Patienten mit systemischer Sklerose und verwandten Erkrankungen ist die folgende Arbeit ein Versuch und eine Diskussionsgrundlage für eine risikoadaptierte Therapiestrategie bei Patienten mit systemischer Sklerose. Dabei liegt ein Hauptaugenmerk auf neuen Therapieoptionen bei Patienten, die mit den etablierten Therapien nur unzureichend behandelt sind und bei denen ein hohes Risiko für schwere Komplikationen oder für eine eingeschränkte Prognose besteht.

Zugleich zeigt die Arbeit mögliche künftige Therapieoptionen auf. Dabei werden u. a. vasoaktive, zelluläre und immunsuppressive Therapien beschrieben.

Abstract

Systemic sclerosis is a challenging disease in terms of early risk assessment and the implications for therapy. The current article draws on a literature analysis and on personal experience of over 450 patients with systemic sclerosis and related illnesses, describing an attempt at a risk-adapted treatment strategy for patients with systemic sclerosis, and is intended to be used as a discussion paper. A major point of emphasis is on novel therapeutic options for patients who are refractory to current treatment strategies and who are at a high risk of serious complications or a limited prognosis. The paper also highlights possible future treatment options, including vasoactive, cellular and immune suppressant treatments.

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Interessenkonflikt

Frau Dr. Riemekasten war mehrfach für die Firmen Encysive, Schering/Bayer und Actelion beratend tätig. Sie hat Honorare für Vorträge erhalten. Diese Firmen, wie auch Novartis, haben teilweise Reisekosten und Studien finanziert.

Frau Professor Dragun hat Honorare für Vorträge und Beratertätigkeit von den Firmen Encysive und Novartis erhalten.

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Authors and Affiliations

  1. Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie der Charité Universitätsmedizin, Centrum 12, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland

    G. Riemekasten

  2. Medizinische Klinik für Nephrologie, Transplantation und Intensivmedizin, Charité Universitätsmedizin, Campus Rudolf-Virchow-Klinikum, Berlin, Deutschland

    D. Dragun

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  1. G. Riemekasten
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  2. D. Dragun
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Correspondence to G. Riemekasten.

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Riemekasten, G., Dragun, D. Risikoadaptierte Therapien bei der systemischen Sklerose. Z. Rheumatol. 66, 672–678 (2007). https://doi.org/10.1007/s00393-007-0225-x

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  • DOI: https://doi.org/10.1007/s00393-007-0225-x

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