Suppr超能文献

系统性硬化症相关间质性肺疾病的个性化医疗

Personalized Medicine for Systemic Sclerosis-Associated Interstitial Lung Disease.

作者信息

Ma Angela, Montesi Sydney B

机构信息

Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114.

出版信息

Curr Treatm Opt Rheumatol. 2025 Dec;11(1). doi: 10.1007/s40674-024-00221-7. Epub 2025 Jan 9.

Abstract

PURPOSE OF THE REVIEW

Systemic sclerosis (SSc) is a rare immune-mediated connective tissue disease with high morbidity and mortality. Interstitial lung disease (ILD) is now the leading cause of death for patients with SSc. While several therapeutic agents have been approved for SSc-ILD, opportunities remain for a personalized medicine approach to improve patient outcomes. The purpose of this narrative review is to summarize the current state of personalized medicine for SSc-ILD and future directions to facilitate earlier diagnosis, disease stratification, prognostication, and determination of treatment response. We also review opportunities for personalized medicine approaches within clinical trial design for SSc-ILD.

RECENT FINDINGS

The management of SSc-ILD remains challenging due to its variable clinical course and current deficits in predicting which individuals will develop progressive pulmonary fibrosis. There have additionally been many challenges in clinical trial design due to limitations in enrichment strategies. Emerging data suggest that serum, radiologic, and other novel biomarkers could be utilized to assess disease activity and treatment response on an individual level.

SUMMARY

Personalized medicine is emerging as a way to address unmet challenges in SSc-ILD and has applicability for identifying stratifying, prognostic, and therapeutic markers for routine clinical care and clinical trial design.

摘要

综述目的

系统性硬化症(SSc)是一种罕见的免疫介导的结缔组织病,发病率和死亡率都很高。间质性肺疾病(ILD)目前是SSc患者的主要死因。虽然已有几种治疗药物被批准用于治疗SSc-ILD,但采用个性化医疗方法改善患者预后仍有机会。本叙述性综述的目的是总结SSc-ILD个性化医疗的现状以及未来方向,以促进早期诊断、疾病分层、预后评估及治疗反应的判定。我们还将综述SSc-ILD临床试验设计中个性化医疗方法的机会。

最新发现

由于SSc-ILD临床病程多变,且目前在预测哪些个体将发展为进行性肺纤维化方面存在不足,其管理仍然具有挑战性。此外,由于富集策略的局限性,临床试验设计也面临诸多挑战。新出现的数据表明,血清、影像学及其他新型生物标志物可用于在个体层面评估疾病活动度和治疗反应。

总结

个性化医疗正在成为解决SSc-ILD中未满足挑战的一种方式,并且适用于识别常规临床护理和临床试验设计中的分层、预后及治疗标志物。

相似文献

1
Personalized Medicine for Systemic Sclerosis-Associated Interstitial Lung Disease.
Curr Treatm Opt Rheumatol. 2025 Dec;11(1). doi: 10.1007/s40674-024-00221-7. Epub 2025 Jan 9.
3
Pharmacological management of systemic sclerosis associated interstitial lung disease.
Expert Opin Pharmacother. 2023 May;24(7):815-824. doi: 10.1080/14656566.2023.2198640. Epub 2023 Apr 13.
4
Detection and classification of systemic sclerosis-related interstitial lung disease: a review.
Curr Opin Rheumatol. 2019 Nov;31(6):553-560. doi: 10.1097/BOR.0000000000000660.
5
Cyclophosphamide for connective tissue disease-associated interstitial lung disease.
Cochrane Database Syst Rev. 2018 Jan 3;1(1):CD010908. doi: 10.1002/14651858.CD010908.pub2.
9
Management of Connective Tissue Disease-related Interstitial Lung Disease.
Curr Pulmonol Rep. 2022;11(3):86-98. doi: 10.1007/s13665-022-00290-w. Epub 2022 May 3.
10
Etiology, Risk Factors, and Biomarkers in Systemic Sclerosis with Interstitial Lung Disease.
Am J Respir Crit Care Med. 2020 Mar 15;201(6):650-660. doi: 10.1164/rccm.201903-0563CI.

本文引用的文献

2
Bexotegrast in Patients with Idiopathic Pulmonary Fibrosis: The INTEGRIS-IPF Clinical Trial.
Am J Respir Crit Care Med. 2024 Aug 15;210(4):424-434. doi: 10.1164/rccm.202403-0636OC.
3
Enrichment Strategies for Systemic Sclerosis-Interstitial Lung Disease Trials.
Am J Respir Crit Care Med. 2024 May 1;209(9):1067-1068. doi: 10.1164/rccm.202401-0246ED.
4
Safety and efficacy of rituximab in systemic sclerosis (DESIRES): a double-blind, investigator-initiated, randomised, placebo-controlled trial.
Lancet Rheumatol. 2021 Jul;3(7):e489-e497. doi: 10.1016/S2665-9913(21)00107-7. Epub 2021 May 26.
6
The identification and management of interstitial lung disease in systemic sclerosis: evidence-based European consensus statements.
Lancet Rheumatol. 2020 Feb;2(2):e71-e83. doi: 10.1016/S2665-9913(19)30144-4. Epub 2020 Jan 14.
7
Systemic sclerosis interstitial lung disease: unmet needs and potential solutions.
Nat Rev Rheumatol. 2024 Jan;20(1):21-32. doi: 10.1038/s41584-023-01044-x. Epub 2023 Nov 3.
8
Phenotyping by persistent inflammation in systemic sclerosis associated interstitial lung disease: a EUSTAR database analysis.
Thorax. 2023 Dec;78(12):1188-1196. doi: 10.1136/thorax-2023-220541. Epub 2023 Oct 5.
10
Progressive pulmonary fibrosis and its impact on survival in systemic sclerosis-related interstitial lung disease.
Rheumatology (Oxford). 2024 Jul 1;63(7):1874-1881. doi: 10.1093/rheumatology/kead491.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验