Polypharmacologic therapy describes the simultaneously inhibition of several targets with one drug. Nintedanib, a multiple tyrosine kinase inhibitor, is an example for this approach because it targets several profibrotic pathways.24 Nintedanib is in a Phase 3 clinical trial for treatment of SSc-related ILD now.
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“Multityrosine kinase inhibitors inhibit a broader spectrum of targeted molecules, and this may provide additional efficacy, but may also be associated with a higher possibility of adverse events,” says Dr. Distler. The heterogeneity of SSc is one challenge for the development of more effective therapies.
“The pathologic pathways may be different in different subsets of patients. That leads to problems in predicting response to treatment,” says Dr. Distler. “We need to better understand the different pathways that lead to different phenotypes in these patients. Progress has been made in this effort, but our classification of different phenotypes is not fine enough yet. We don’t fully understand the pathogenesis of this disease. We have so much more to do.”
Susan Bernstein is a freelance medical journalist based in Atlanta.
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