Volume 12 Issue 5, May 2016

New guidance issued by NICE in the UK addresses issues of when and for whom to introduce biologic drugs, including biosimilars, in the treatment of rheumatoid arthritis. Could differences between these recommendations and those of national societies have implications for patient care?

Familial Mediterranean fever is a rare disorder but is usually easy to manage using colchicine. The publication of a severity score could serve as a useful reminder to rheumatologists about this disease and the difficulties in assessing its severity.

Macrophage activation syndrome (MAS) is a potentially fatal complication of rheumatic disease, most notably systemic juvenile idiopathic arthritis. Findings from studies in animal models and from clinical observations, particularly in relation to the effects of anticytokine biologic therapies, have led to new concepts of the pathophysiology of this phenomenon.

In the setting of inflammatory diseases, metabolic profiling has potential applications in diagnosis, monitoring and defining disease pathogenesis. This Review focuses on metabolomic studies in rheumatic diseases, including discussion of state-of-the-art technologies, recent insights into disease mechanisms and treatment targets, and the feasibility of metabolomics for biomarker discovery.

The availability of new agents to treat patients with spondyloarthritis and the results of clinical trials published in the past few years provide new perspectives on the optimal management of these patients. In this article, Sieper and Poddubnyy review the current options for management of axial and peripheral spondyloarthritis on the basis of the latest evidence.

The influence of adipokines on the pathogenesis and progression of rheumatic diseases is increasingly appreciated. In particular, these factors have complex roles not only in inflammation, but in tissue remodelling. This Review focuses on the effects of distinct adipokines on bone cells and bone remodelling, and discusses whether these mechanisms could be targeted therapeutically.

In patients with symptomatic femoroacetabular impingement (FAI), early correction of the anatomical dysfunction could delay or prevent the development of hip osteoarthritis. Accordingly, the past 5 years has seen a huge increase in minimally invasive, arthroscopic correction of FAI and a correspondingly rapid rise in FAI-related research. Khan and colleagues discuss the clinical evidence and emerging concepts of the pathophysiology, biomechanics and management of FAI.