Current management strategies for systemic sclerosis

Systemic sclerosis remains a challenging disease despite progress that has taken place in the management of organ-based complications. Overall management strategies need to take into account the features of the disease that are common to almost all patients such as skin involvement, gastro-oesophageal manifestations and secondary Raynaud's, as well as identify less frequent but critical manifestations that impact on survival including heart, lung, renal and more severe GI involvement. Treatments can be considered to be disease-modifying or symptomatic. In addition, it is important to address more generic problems such as the emotional, psychological and economic impact of a chronic autoimmune rheumatic disease. This article reviews general approaches to disease assessment and management and relates this to subset and stage of the condition.