Volume 13 Issue 12, December 2017

TNF inhibition is associated with an increased risk of lymphoma development. But is this association due to the TNF inhibitors themselves or the patient's underlying disease?

Gout and osteoarthritis are known to coexist in certain joints, with urate and calcium crystals being associated with the development of osteoarthritis. Now, research is shedding light on the depth of this association and bringing surprising observations to the fore.

An unmet need exists for effective glucocorticoid-sparing agents for the treatment of giant cell arteritis (GCA). Tocilizumab, the first intervention to demonstrate substantial therapeutic benefits for patients with newly diagnosed or relapsing GCA, is changing the landscape of treatment and ushering in a new era of biologic therapy.

Biosimilar therapeutics for immune-mediated disease are approved in many countries and are increasingly being utilized in clinical practice. Although much has been written about the effectiveness and safety of biosimilars, less focus has been placed on why, how and when (or when not) to use these medications — until now.

For patients with osteoarthritis, the current palliative approach of analgesic prescription followed by joint replacement is often inappropriate. Instead, care should be tailored to the needs of individuals and targeted towards the central complaints of pain and functional limitation. So why are we still getting it wrong?

Identifying different phenotypes of osteoarthritis is currently a subject of much research; however, a new systematic review has sparked discussion about the discrepancies in how research into disease phenotypes is conducted. Can we define individual phenotypes if we cannot agree on what constitutes a phenotype in the first place?

Primary and secondary failure of TNF antagonists can affect treatment strategies for rheumatoid arthritis. This article discusses the implications of immunogenicity, as well as methodological problems related to the detection of antidrug antibodies and trough drug levels.

In the past few years, excitement has grown over the potential use of mesenchymal stem cells (MSCs) for cartilage repair, although the rarity of these cells has hampered progress. In this Review, the authors examine the potential of joint-resident MSCs as a new avenue for repair in osteoarthritis.

This article provides an overview of the pathophysiology of enthesitis, from induction and inflammation to tissue proliferation and bone formation. Building on these pathophysiological concepts, the clinical presentation, assessment and treatment of enthesitis are also discussed.

Symptoms associated with chronic inflammatory diseases such as fatigue, depression and muscle loss are often overlooked during treatment. This Perspectives article provides a framework for understanding many of these symptoms that is based on the concepts of evolutionary medicine, energy regulation and neuroendocrine–immune crosstalk.