Lescoat, Alain;
Bellando-Randone, Silvia;
Campochiaro, Corrado;
Del Galdo, Francesco;
Denton, Christopher P;
Farrington, Sue;
Galetti, Ilaria;
... Matucci-Cerinic, Marco; + view all
(2023)
Beyond very early systemic sclerosis: deciphering pre‑scleroderma and its trajectories to open new avenues for preventive medicine.
The Lancet Rheumatology
, 5
(11)
E683-E694.
10.1016/S2665-9913(23)00212-6.
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Abstract
The identification of individuals with systemic sclerosis in an oligosymptomatic phase preceding the very early manifestations of the disease represents a challenge in the search for a new window of opportunity in systemic sclerosis. This phase could be identified in a clinical scenario as the pre-scleroderma phase, in which the disease would still be far from systemic sclerosis-related fibrotic or irreversible manifestations in skin or organs. In this Personal View, we discuss parameters and candidate definitions for a conceptual framework of pre-scleroderma, from the identification of populations at risk to autoantibodies and their potential functional activities. We discuss how this new paradigm of pre-scleroderma could represent a game-changing approach in the management of systemic sclerosis, allowing the treatment of patients at high risk of organ involvement or skin fibrosis before such events occur.
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