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Prospects for Stratified and Precision Medicine in Systemic Sclerosis Treatment

Clark, KEN; Derrett-Smith, E; (2019) Prospects for Stratified and Precision Medicine in Systemic Sclerosis Treatment. Current Treatment Options in Rheumatology , 5 (3) pp. 201-212. 10.1007/s40674-019-00124-y. Green open access

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Abstract

Purpose of review Precision medicine is an evolving field stemming from Oncology research, with an increasingly important role in autoimmune diseases. The heterogeneity, both of clinical presentations of systemic sclerosis and differing response to treatment, emphasises the importance of developing means of patient stratification to ensure that the correct patients are managed with the most appropriate treatments at a disease duration when this will have meaningful impact on disease course and resolution. This review aims to discuss the different means explored so far in stratifying patients with systemic sclerosis. We highlight recent clinical trials which have applied stratification techniques in order to provide a form of precision medicine in the management of systemic sclerosis. Recent findings Advances have focused on utilising gene expression techniques on whole skin biopsies or fibroblasts to understand which groups of patients are more likely to respond to which treatments. This technique has been used successfully to understand the effect of tocilizumab, abatacept, and fresolimumab on systemic sclerosis, and helped identify those that are more likely to respond to treatment. Summary Utilising high output platforms to stratify patients for targeted treatment is still in its infancy but has huge potential for ensuring the patients most likely to respond to a specific therapy are put forward to trials. It has already been shown to be successful in those with a high IL-6 profile and will most likely prove hugely informative in the future.

Type: Article
Title: Prospects for Stratified and Precision Medicine in Systemic Sclerosis Treatment
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s40674-019-00124-y
Publisher version: https://doi.org/10.1007/s40674-019-00124-y
Language: English
Additional information: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Systemic sclerosis . Scleroderma . Stratification . Biomarkers . Gene expression
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10079549
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