title: Clinical trials in systemic sclerosis: lessons learned and outcomes.
abstract: The pathogenesis of systemic sclerosis (SSc) is complex and largely unclear. The clinical heterogeneity of the disease and its progression over a number of years makes the choice of endpoints in the design of clinical trials difficult. The overwhelming need in this disease is to diagnose it early and identify those patients who will benefit most from early, aggressive treatment that potentially can alter the clinical disease course. To achieve this, innumerable challenges must be overcome. This article reviews data from recent clinical trials and the lessons derived from retrospective observational studies, databases, and patient registries. Taken together, these observations will help to improve our understanding of the diverse clinical course of SSc and permit refinement of existing outcome measures for the design of future clinical trials, in which the likelihood of observing a positive treatment effect with the drugs at our disposal will be maximized.
authors.affiliation: Division of Medicine and Surgery, Division of Medicine I and Rheumatology, Villa Monna Tessa, Viale Pieraccini, I-50139 Florence, Italy. cerinic@unifi.it
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci-Cerinic
authors.forename: Virginia D
authors.initials: VD
authors.lastname: Steen
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Furst
authors.forename: James R
authors.initials: JR
authors.lastname: Seibold
mesh_terms: D000818:Animals; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods* / Q000639:trends; D012595:Scleroderma, Systemic / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome