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Guidelines for access to biologic therapies vary considerably between different nations. In this Viewpoint, Drs Deighton and Hyrich discuss the pros and cons of current guidelines for anti-tumor necrosis factor therapy in patients with rheumatoid arthritis, and recommend a number of elements that should be included in future guidelines.
Hypermobility-related disorders are frequently encountered in clinical practice, but are too often dismissed as trivial. In this Viewpoint, Prof. Grahame discusses why the current perception of these disorders is inadequate, and highlights recent advances in the field as well as challenges and opportunities for future research and therapy.
Glucocorticoids are powerful and cost-effective drugs for the treatment of patients with rheumatic disease; however, currently available glucocorticoids have several adverse effects. This Review describes the genomic and nongenomic mechanisms of glucocorticoid action; detailed knowledge of these mechanisms is crucial for researchers to develop novel glucocorticoid receptor ligands and/or to further improve the use of currently available conventional glucocorticoids.
MicroRNAs (miRNAs) have been implicated in the pathogenesis of rheumatic disease and are, therefore, a potential target for drug development. This Review describes the well-established roles of miRNAs in hematopoiesis and the immune response, the molecular action of miRNAs in the simultaneous post-transcriptional regulation of multiple targets, and the evidence for roles of specific miRNAs in rheumatic disease.
'Growing pains' is a term that has been applied for almost 200 years to describe and diagnose some forms of childhood limb pain. To date no clear mechanism has been identified. The authors present a thorough historical Review of the physical presentation, differential diagnoses, potential causative factors and management options for this phenomenon.
Osteoarthritis is a progressively degenerative joint condition that is influenced by various metabolic and structural factors. In this third in a series of three Reviews on Wnt–β-catenin signaling, Dr Corr provides insights into recent advances in research into the role of Wnt signaling in the pathogenesis of osteoarthritis, and discusses some of the genetic and regulatory factors involved.
This Case Study illustrates the differential diagnosis and management of nephrogenic systemic fibrosis, a progressively debilitating fibrosing disorder. The authors describe the case of a 60-year-old woman with chronic renal disease who presented with progressive stiffness in her arms and legs following exposure to gadolinium-containing contrast media.
