Panopoulos S, Chatzidionysiou K, Tektonidou MG, et al. - In this study, current treatment modalities and drug survival in a real-life systemic sclerosis (SSc) cohort were presented. Between 2016 and 2018, researchers retrospectively recorded details on immunosuppressive/antiproliferative (methotrexate, mycophenolate, cyclophosphamide, azathioprine, rituximab, tocilizumab) and vasoactive agent [(endothelin receptor antagonists (ERAs), sildenafil, iloprost, and calcium channel blockers] administration during the disease course (11.8 ± 8.4 years, mean + SD) of 497 consecutive individuals. Kaplan–Meier analysis tested drug survival. For successful management of SSc, existing therapeutic limitations demonstrate that more evidence-based treatment is needed. The outcomes indicated that vasculopathy appears to be managed more rigorously, but the low retention rates of immunosuppressive/antiproliferative drugs advocate that effective and targeted disease-modifying agents are warranted.