Therapeutic Approaches in Systemic Sclerosis – What’s Old and What’s New? A Literature Review

Introduction: Systemic sclerosis (SSc) is an autoimmune disease that, because of its heterogeneity, presents clinicians with many therapeutic challenges. The hallmarks of its pathogenesis are vasculopathies, cutaneous or visceral fibrosis and the presence of scleroderma-related antibodies, however, the course of the disease is different in every case. Therefore it is important to adjust the treatment process individually to each patient's needs. In this manuscript we aim to describe options available for therapeutic management of SSc. Materials and methods: An electronic literature search was performed using PubMed, Cochrane Library and Evidence-Based Medicine Reviews. Search terms included “systemic sclerosis”, “methotrexate”, “mycophenolate mofetil” “cyclophosphamide”, “autologous hematopoietic stem cell transplantation”, “tocilizumab”, “nintedanib”, “belimumab”, “rituximab”, “abatacept”, “lenabasum” as keywords. The review focused on articles published in English from their inception until 2025. Conclusions: However, the disease-modifying anti-rheumatic drugs are widely used in systemic sclerosis, currently the biological therapeutics are objects of dynamic researches due to their good benefit-risk ratio. Numerous biological drugs are implemented for alleviating the course of Interstitial Lung Disease as it remains main cause of death among SSc patients. Additionally, some clinical manifestations of SSc, including Raynaud phenomenon (RP) and Pulmonary Artery Hypertension (PAH) are treating rather symptomatically then causatively. We hope our manuscript contributed to better understanding of therapeutic approaches of systemic sclerosis.