Volume 11 Issue 10, October 2015

In the past decade, the consequences of temporomandibular joint arthritis in patients with juvenile idiopathic arthritis have received increasing attention. Intra-articular corticosteroid injections have been suggested as a treatment option, but concerns that this treatment could reduce mandibular growth have been raised and are supported by new data published in The Journal of Rheumatology.

Although new therapeutic options are available for patients with autoinflammatory diseases, evidence-based treatment guidelines are lacking. An initiative in European paediatric rheumatology aims to develop best-practice recommendations for the management of these rare disorders.

Early identification of secondary Raynaud phenomenon is essential to treat the underlying disease—most frequently systemic sclerosis (SSc). Integrated therapeutic approaches and monitoring systems that offer improved modalities of care feature in the new best practice recommendations for the treatment of digital vasculopathy in SSc.

The focus of translational research approaches on complex multifactorial diseases has enabled a deeper understanding of the pathophysiological mechanisms involved, and translated into new therapies that advanced management of autoinflammatory diseases considerably. In parallel to these developments, the successful use of strategies such as IL-1-blockade to treat patients with systemic-onset juvenile idiopathic arthritis or TNF receptor-associated periodic syndrome has led, through reverse translational approaches, to a better understanding of the pathophysiological role of these cytokines in autoinflammatory conditions. In this Review, Holzinger et al. describe how forward and reverse translational research have yielded important insights into the pathogeneses of autoinflammatory diseases, and explores the future challenges in the field.

Some aspects of the management of antiphospholipid syndrome (APS) are supported by abundant high-quality evidence, but, in certain scenarios, decisions are based on clinical judgement and experience. This comprehensive Review surveys the current recommendations for treating thrombotic and obstetric manifestations of APS, and addresses several areas of controversy in APS diagnosis and management.

Musculoskeletal conditions are major contributors to the global burden of disease, but research to improve musculoskeletal health care is underfunded, not optimally planned, and the results often do not change clinical practice. Evidence suggests that improving the validity of clinical research and the implementation of practice change can improve health care.

Osteoarthritis (OA) and rheumatoid arthritis (RA) are disorders of the joints that involve degradation of the extracellular matrix of cartilage, and proteases and inflammatory mediators are common to both conditions. However, different cells are affected in OA (chondrocytes) and RA (synoviocytes), and treating these diseases requires an understanding of their differences as well as their similarities.

This concise overview of the development of new therapeutics for systemic lupus erythematosus (SLE) in the past few decades considers the agents that have been tested and highlights the evolution of clinical trial design, assessment tools and outcome measures, and also provides a glimpse of several new innovations that are likely to shape drug discovery in SLE in the near future.