Review article
Stratified medicine approach for systemic sclerosis: state of the art and the need for clinical biomarkers
* Sam Straw
Abstract:
Systemic sclerosis (SSc) is a highly heterogeneous disease which would benefit from the adoption of a stratified medicine approach, to improve outcomes for patients and reduce costs to the healthcare system. SSc is orphan of disease activity biomarkers, as the current gold standard prognostic test: the modified Rodnan skin score (MRSS) is flawed. The MRSS has been shown to be unreliable, insensitive to change and not specific in measuring skin fibrosis. Physical measurements of skin thickness, genetic risk factors and autoantibodies may all allow patient stratification, however as proteins are the mediators of biological function; proteomics may offer the best approach. Proteomic studies to identify biomarkers are hypothesized to fulfill the outcome measured in rheumatology (OMERACT) filter criteria of: truth, discrimination and feasibility.
Key words: Stratified medicine; scleroderma; systemic sclerosis; biomarkers; health economics; modified Rodnan skin score; OMERACT; proteomics; autoantibodies; genetic risk factor; skin thickness.
Affiliation:-
*Medical student, Scleroderma Research Group, Leeds Institute of Molecular Medicine, St James’ University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
*Corresponding author:
Sam Straw.
Medical student, Scleroderma Research Group, Leeds Institute of Molecular Medicine, St James’ University Hospital, Beckett Street, Leeds, LS9 7TF, UK