Great strides have been made in identifying and managing the organ-based complications of @entity785 ( @entity785 ). There is no room for the nihilism towards treating this disease that used to be so prevalent. However, there is still relatively little hard evidence on which to base treatment decisions. Previous trials have been constrained by the low disease prevalence and the difficulty in recruiting sufficient @entity1 especially with disease of recent onset. The results of past trials have often been confounded by the failure to recognize the marked heterogeneity of @entity785 and the inclusion of @entity1 subsets with widely varying disease expression, course and outcome. It is recognized that progress will only be made in this area with coordinated multicentre studies. As a result, national and international networks of clinicians with expertise in the management of @entity785 have been formed. In the UK, the @entity785 Study Group has established a national @entity2631 register and, together with the @entity2631 Special Interest Group of the British Society for Rheumatology (BSR), a multicentre base for therapeutic studies. As a result of developments in our understanding of the pathogenesis of @entity2631 and our ability to subset @entity1 more effectively, a number of rather more rational approaches to treating the disease and its complications are being tested. In parallel with this, considerable progress is being made in developing universally agreed measures of disease activity and severity and in identifying surrogate laboratory markers of disease activity that are relevant to therapeutic studies. These multicentre trials need substantial funding and often do not attract support from the pharmaceutical industry. It was because of the difficulty in financing long-term, multicentre studies in uncommon conditions that the ARC/BSR Clinical Trials Programme was established. The QUINS trial, which is funded by this Programme, is described here as an example of one of several therapeutic protocols being developed by the UK @entity785 Study Group that are currently being tested in multicentre trials. Contact details are provided in the appendix for clinicians who are interested in registering @entity1 on the UK @entity2631 Register or participating in this or in the other therapeutic studies.

Prevention of vascular damage in XXXX with angiotensin-converting enzyme (ACE) inhibition.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity2631 :: ('MESH:D012594', 'Disease') :: ['Scleroderma', 'scleroderma'] @entity785 :: ('MESH:D012595', 'Disease') :: ['Systemic Sclerosis', 'systemic sclerosis', 'SSc']
@entity2631 :: (MESH:D012594,Disease) :: ['scleroderma']
