Volume 12 Issue 12, December 2016

An unmet need exists for more-effective and selective therapeutics in systemic lupus erythematosus. Advances in understanding of the pathogenetic mechanisms of this severe autoimmune disease have led to the clinical translation of low-dose IL-2 therapy, which primarily aims to restore the activity of regulatory T cells.

The concept of treating to a target of remission is gaining ground in systemic lupus erythematosus. New research suggests that achievement of this treatment goal is rare, but are the definitions of remission used in these studies fit for purpose?

Sedentary behaviour is reported to have adverse consequences for metabolic, functional and cardiovascular health — outcomes already prevalent in patients with rheumatoid arthritis (RA). This commentary considers the relevance of sedentary behaviour in the context of RA, highlighting the limitations of past work and offering suggestions for a new research agenda.

Despite conflicting evidence from clinical trials, rituximab continues to be used off-label in the treatment of systemic lupus erythematosus (SLE). A new study has now investigated the use of this drug for SLE in Europe, including indications for use and patient characteristics.

Dendritic cells are key regulators of both immunity and tolerance, and display a remarkable functional heterogeneity. In this Review, the authors discuss how the function and distribution of different dendritic cell subsets change in autoimmune diseases.

In this Review, Tsokos et al. describe recent advances in our understanding of systemic lupus erythematosus (SLE) that are driving repurposing of existing drugs as well as development of new treatments. Cytokines, tolerance pathways, local tissue mediators, and epigenetic mechanisms all show promise as novel targeted therapies that could lead to individualized care in SLE.

Methotrexate remains the first-line therapy for rheumatoid arthritis (RA). However, not all treated patients respond, and its mechanism of action remains incompletely understood. This Review describes putative mechanisms of action of methotrexate at the low doses used in RA and discusses potential biomarkers of treatment response, which could ultimately inform precision use of this therapy.

In 2016, two international organizations published recommendations for the management of psoriatic arthritis. This article reviews the development of the recommendations, considers their similarities and differences, and provides guidance on how to interpret and apply the recommendations in practice.