Prospects for Stratified and Precision Medicine in Systemic Sclerosis Treatment

Journal article

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

Authors: Clark, KEN; Derrett-Smith, E

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer Science and Business Media LLC
• Journal: Current Treatment Options in Rheumatology
• Volume: 5
• Issue: 3
• Pages: 201-212
• Publication date: 2019-05-20
• DOI: 10.1007/s40674-019-00124-y
• EISSN: 2198-6002
• ISSN: 2198-6002
• Language: English
• Keywords: Internal medicine; Multiple sclerosis; Intensive care medicine; Oncology; Personalized medicine; Bioinformatics; Clinical trial; Cancer; Medicine; Pathology; Abatacept; Tocilizumab; Systemic therapy; Immunology; Scleroderma (fungus); Disease; Precision medicine; Rituximab