How can treatment of systemic sclerosis be improved?

BMJ 1998;317:294-295 ( 1 August )

Editorials

How can treatment of systemic sclerosis be improved?

By setting up a national database of all cases and entering patients into trials

The first 150 words of the full text of this article appear below.

Systemic sclerosis is a rare disease (about 10 cases/1 000 000/year) with a substantially higher mortality than other autoimmunerheumatic diseases.¹ This, and an even greater morbidity, makeit an unwelcome diagnosis for clinicians and a fearful one forpatients. No cure exists, though much can be done to alleviatethe organ based complications of the condition, and many differentagents are used in an attempt to modify disease progression. Unfortunately,few drugs have been properly evaluated in clinical trials andeven the standard treatments are not of proved efficacy.² Moreaggressive therapies are now being tried in some centres $---$ for example,immunoablation with autologous peripheral stem cell rescue³ $---$ andthere is an urgent need to compare these novel regimens with standardtreatments. How can we improve the management of this conditionand ensure that management is based on the best possible evidence?

Research over the past 20 years has led to a clearer . . . [Full text of this article]

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