Your Scleroderma Questions, Answered is a monthly Q&A column featuring responses from the SRF’s Chief Medical Officer, Dr. Gregory Gordon, who shares guidance grounded in decades of clinical expertise.
In this edition, he answers questions about the concept of ‘remission’ within scleroderma care, and how to navigate scleroderma treatment while living with another autoimmune disease.
Question: What does ‘remission’ mean or look like for systemic sclerosis patients?
Answer: Doctors rarely use the word ‘remission’ for scleroderma. It is more common in cancer. There, remission means that tests, such as CT scans, no longer show any signs of the cancer and the patient has no symptoms.
In scleroderma, doctors more often say the disease has stabilized. This means the disease has stopped getting worse. Tests of the lungs, heart and other organs stay about the same over time. Some symptoms may continue, and many people need ongoing medicine to stay stable. Stabilization is an important goal, because it helps protect organ function over time.
Stabilization is not the same as a cure. Damage that has already happened usually does not go away, but it is no longer getting worse. Doctors will usually continue regular tests to confirm the disease remains stable.
Question: How do you navigate scleroderma alongside another autoimmune disease?
Answer: Many people with scleroderma also have a second autoimmune disease. This happens to roughly 1 in 4 patients. Common examples include Sjögren’s disease, rheumatoid arthritis and lupus.
Having more than one autoimmune condition can make diagnosis more complicated. Blood tests for antibodies linked to each disease, along with each disease’s typical symptoms, can help tell them apart. However, some symptoms overlap, and it may be hard to tell which disease is causing a symptom. More tests may be needed to find the cause and decide how treatment should change.
Treatment can also be more complicated, because each condition may need its own care. Some medicines work across several autoimmune diseases, so a single medicine may treat both conditions. Others are more targeted, and they need to fit with the rest of the treatment plan so that all medicines can be used safely together.
Your rheumatologist can work with your other doctors to coordinate your care. This helps make sure you get the right follow-up across different specialties and that treatment for other conditions does not interfere with treatment for your autoimmune conditions.
