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 Table of Contents  
LETTER TO EDITOR
Year : 2016  |  Volume : 11  |  Issue : 4  |  Page : 239

Author's response


1 Division of Rheumatology, Department and Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
2 Centre for Rheumatology and Connective Tissue Diseases, UCL Medical School, Royal Free Campus, London NW3 2QG, UK

Date of Web Publication8-Nov-2016

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-3698.193591

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How to cite this article:
Raja J, Denton CP. Author's response. Indian J Rheumatol 2016;11:239

How to cite this URL:
Raja J, Denton CP. Author's response. Indian J Rheumatol [serial online] 2016 [cited 2019 Nov 20];11:239. Available from: http://www.indianjrheumatol.com/text.asp?2016/11/4/239/193591

Dear sir,

Delighted that the authors have interest in our article and welcome the additional information that is provided in their letter. Space limitation prevented all possible treatment approaches being discussed in detail and the comments about potential benefits of PDE5i are certainly relevant. These are also aligned with the major clinical trial that is underway at present examining possible anti-fibrotic benefit of a soluble guanylate cyclase agonists (riociguat) in systemic sclerosis skin disease (“http://clinicaltrials.gov/” ClinicalTrials.gov Identifier: NCT02283762). However fibrosis in systemic sclerosis and other conditions is complex and more studies are needed to understand this potential better. For example, there are also some potential concerns from studies of idiopathic lung fibrosis where vasodilator therapies may be disadvantageous in some cases. In line with recent expert recommendations, the widespread use of PDE5 inhibitors for digital vasculopathy and pulmonary arterial hypertension in SSc will hopefully help to answer some of these outstanding questions.




 

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