Bias, conflict of interest and publishing
Peter E. Lipsky
p175 | doi:10.1038/nrrheum.2009.52
Table of contents
April 2009 Vol 5 No 4
Free Sample Issue
Full text content of the April 2009 issue is freely available in both HTML and PDF formats.
Editorial
Research Highlights
Connective tissue diseases: Undoing the damage caused by systemic sclerosis | PDF (188 KB)
p177 | doi:10.1038/nrrheum.2009.56
In brief
Bone diseases | Autoimmunity | Experimental arthritis | Rheumatoid arthritis | PDF (49 KB)
p178 | doi:10.1038/nrrheum.2009.44
Rheumatoid arthritis: Predicting RA progression | PDF (114 KB)
p178 | doi:10.1038/nrrheum.2009.57
Experimental arthritis: Exploiting IL-6 trans signaling targets collagen-induced arthritis | PDF (62 KB)
p179 | doi:10.1038/nrrheum.2009.58
Rheumatoid arthritis: Anti-MCV antibodies—a promising new biomarker for RA | PDF (60 KB)
p179 | doi:10.1038/nrrheum.2009.59
IL-3 prevents inflammatory arthritis | PDF (52 KB)
p180 | doi:10.1038/nrrheum.2009.60
Rheumatoid arthritis: Do steroids increase metabolic syndrome risk? | PDF (77 KB)
p180 | doi:10.1038/nrrheum.2009.61
In brief
Autoimmunity | Rheumatoid arthritis | Experimental arthritis | Spondyloarthropathies | PDF (50 KB)
p181 | doi:10.1038/nrrheum.2009.45
Inflammation: SIGN here for anti-inflammatory activity! | PDF (1,365 KB)
p181 | doi:10.1038/nrrheum.2009.62
Connective tissue diseases: Autoantibody profiles linked to ethnicity in pediatric SLE | PDF (58 KB)
p182 | doi:10.1038/nrrheum.2009.32
Rheumatoid arthritis: PlGF's role extends beyond angiogenesis | PDF (56 KB)
p182 | doi:10.1038/nrrheum.2009.35
News and Views
Vasculitis syndromes: Vasculitis therapy—between Scylla and Charybdis
Richard Watts
p183 | doi:10.1038/nrrheum.2009.46
Achieving effective maintenance therapy with minimal adverse effects for patients with antineutrophil cytoplasmic autoantibody associated vasculitis is a major challenge facing the vasculitis community. A study by Pagnoux et al. shows that azathioprine and methotrexate have similar efficacy and adverse event profiles when used for remission maintenance in these patients.
Therapy: Are TNF inhibitors safe in pregnancy?
Monika Østensen
p184 | doi:10.1038/nrrheum.2009.47
Tumor necrosis factor inhibitors are fast acting, highly effective and well tolerated by the majority of patients, but their safety in pregnant women remains a matter of debate. The latest research weighs in on the issue.
Therapy: Methotrexate guidelines: compromise to reach consensus
Joel M. Kremer
p186 | doi:10.1038/nrrheum.2009.41
Practice in relation to administration of methotrexate varies considerably despite its prominent place in the treatment arsenal for various rheumatic diseases. A multinational initiative has developed recommendations, based on the literature and in consultation with a large panel of rheumatologists, for use of this drug.
Genetics: Unraveling the genetics of autoimmune disease
Timothy J. Vyse
p187 | doi:10.1038/nrrheum.2009.42
The ability to conduct genetic association studies on a genome-wide scale has revolutionized approaches to reveal the genetic basis of autoimmune diseases. A comparison by Zhernakova and colleagues of the known susceptibility genes in 11 immune-related diseases reveals evidence for shared gene effects and common pathogenetic mechanisms.
Fibromyalgia: A new treatment option for fibromyalgia
Robert M. Bennett
p188 | doi:10.1038/nrrheum.2009.48
The FDA's approval of milnacipran reflects advances in the development of drugs aimed at modulating pain circuitry in fibromyalgia.
Reviews
A symptom-based approach to pharmacologic management of fibromyalgia
Chad S. Boomershine & Leslie J. Crofford
p191 | doi:10.1038/nrrheum.2009.25
In the context of a multidisciplinary approach to the management of fibromyalgia, guidelines recommend that pharmacologic therapies be individually tailored to a patient's symptoms but do not offer a method of assessment. In this Review, the authors provide a rapid, easily-remembered framework for the quantitation and pharmacologic management of symptoms that is suitable for use in a busy clinical practice.
Transforming growth factor 
as a therapeutic target in systemic sclerosis
John Varga & Boris Pasche
p200 | doi:10.1038/nrrheum.2009.26
In patients with systemic sclerosis, impaired activity of transforming growth factor 
(TGF-) has a central role in the pathogenesis of fibrosis, which leads to the progression of the disease and severe organ damage. In this context, the authors discuss the mechanisms of aberrant TGF- signaling and highlight the potential of TGF- as a therapeutic target in systemic sclerosis.
Management of cardiovascular disease risk in chronic inflammatory disorders
Mariana J. Kaplan
p208 | doi:10.1038/nrrheum.2009.29
A wealth of evidence suggests that the prevalence of cardiovascular disease is increased in patients suffering from chronic inflammatory disorders, particularly rheumatoid arthritis and systemic lupus erythematosus, as discussed in this Review. In the absence of specific guidelines, Dr Kaplan highlights strategies for the prevention and treatment of cardiovascular events in patients with chronic inflammatory disease.
Periodontitis in systemic rheumatic diseases
Paola de Pablo, Iain L. C. Chapple, Christopher D. Buckley & Thomas Dietrich
p218 | doi:10.1038/nrrheum.2009.28
A potential association between periodontitis, a chronic inflammatory disease characterized by loss of the periodontal ligament and alveolar bone, and systemic rheumatic diseases—particularly rheumatoid arthritis—has been suggested. Results from studies that support such a link are outlined in this article, as are causal and non-causal factors that could determine an association between the two conditions.
Case Study
Rapidly progressive fatal interstitial lung disease in a patient with systemic sclerosis
Kristine Phillips, Cathryn Byrne-Dugan, Eric Batterson & James R. Seibold
p225 | doi:10.1038/nrrheum.2009.30
Interstitial lung disease is a common manifestation of systemic sclerosis, and often leads to death in these patients. These authors describe the case of a previously healthy woman with acute systemic sclerosis who experienced an unusually fulminant course of interstitial lung disease, which did not respond to treatment with intravenous cyclophosphamide.
Perspectives
Opinion
The cholinergic anti-inflammatory pathway: towards innovative treatment of rheumatoid arthritis
Marjolein A. van Maanen, Margriet J. Vervoordeldonk & Paul P. Tak
p229 | doi:10.1038/nrrheum.2009.31
Evidence is mounting that the cholinergic pathway is involved in the pathogenesis of rheumatoid arthritis and other immune-mediated inflammatory disorders. This timely article provides an overview of the role of the vagus nerve and 
7 nicotinic acetylcholine receptor in this pathway, and highlights novel strategies that could exploit these targets in the treatment of rheumatic diseases.
