Rheumatology researchers are beginning a five-year project to look at a potential treatment for painful and disabling skin tightening in people with systemic sclerosis (also called scleroderma).
They have been awarded £367,593 by Arthritis Research UK for the study, which will examine whether an oral steroid, prednisolone, can ease the skin tightening, pain and disability which affects patients who have the early diffuse cutaneous type of systemic sclerosis.
Systemic sclerosis is a connective tissue disease which leads to skin thickening and damage to blood vessels, and which can also affect organs such as the heart, lungs, digestive tract and kidneys. There is no cure at present but some of the symptoms can be treated.
The skin tightening can be a major source of discomfort and disability, particularly affecting the use of the hands. In patients with the diffuse cutaneous type, the skin tightening can progress rapidly, usually involving the hands and feet first but then progressing to involve other parts of the body.
It’s the first time a randomised controlled study has been carried out on using steroid treatment for this condition and it’s an area where clinicians’ views differ. In particular, there are concerns that the use of steroids could be a risk factor for kidney problems.
Professor Ariane Herrick, Honorary Consultant Rheumatologist at Salford Royal and Professor of Rheumatology at The University of Manchester, explained: “It’s a very disabling condition – the skin tightening starts in the hands and feet but spreads rapidly, causing pain and affecting how patients can use their hands.
“Patients can become very distressed by these symptoms so we are keen to see what we can do to give them a better quality of life.
“We are very grateful to Arthritis Research UK for recognising this as an important issue and supporting this research.”
Prof Herrick is Principal Investigator for the study on behalf of the UK Scleroderma Study Group and is working with co-applicants Prof Christopher Denton (Royal Free, London), Dr Marina Anderson (University of Liverpool), Dr Maya Buch (University of Leeds), Dr John Pauling (University of Bath) David Ryder (MAHSC) and Dr Bridget Griffiths (Freeman Hospital, Newcastle).
Salford Royal, which is a specialist centre for systemic sclerosis and sees patients from all over the North West, will be one of around 12 centres for the study which is due to start this spring. The researchers hope to recruit 72 patients, with the study group receiving the steroid treatment for six months and a control group being given a placebo.
The patients involved will be asked to report back on their symptoms as well as having their skin and other aspects of their illness checked by their clinician.