Volume 12 Issue 6, June 2016

Cardiovascular events are a major cause of death in patients with rheumatoid arthritis (RA). Recent data suggest that TNF inhibition can reduce both disease activity and the risk of acute coronary syndrome, adding to our knowledge of how RA therapies modify cardiovascular risk.

Clinical trial data suggest the IL-6-targeted drug clazakizumab ameliorates the symptoms of psoriatic arthritis (PsA), in particular the musculoskeletal manifestations of the disease. Could this new treatment hold promise for a certain subgroup of patients with PsA?

Although paracetamol is widely used and recommended for the management of pain in osteoarthritis, accumulating data indicate that it lacks efficacy and is associated with severe adverse effects. A new meta-analysis adds further weight to calls for clinical practice and treatment guidelines to be updated to reflect the evidence.

In this Review, Karasik et al. summarize key advances from the past 5 years in understanding the genetics of bone traits and osteoporosis. Despite the wealth of new genetic and genomic information, its application to the clinical management of osteoporosis remains in its infancy. The notable advances made in gene discovery suggest that the next decade will witness cataloguing of hundreds of genes that influence bone mass, which, in turn, will provide a roadmap for the development of new bone-focused drug targets.

Family history remains a strong independent risk factor for developing rheumatoid arthritis (RA). This Review provides an overview of the ways in which familial aggregation has been evaluated, discusses what these studies can tell us about the aetiology of RA, and considers the potential value of family history of RA for clinical care and for research.

In the past few years, substantial progress has been made in our understanding of the role of Toll-like receptors (TLRs) in inflammatory diseases. Joosten and colleagues discuss the role of TLRs in the pathophysiology of rheumatic diseases and how TLRs and TLR signalling pathways can be targeted to treat these conditions.

In comparative effectiveness research (CER) in the field of rheumatoid arthritis, the preferred source of data is drug and disease registries, whereas administrative health databases have commonly been used to examine safety and cost-effectiveness. Although the use of administrative health databases to investigate effectiveness poses unique methodological challenges, it also offers distinct advantages.

Ehrenstein and Wing assert that rituximab re-treatment can trigger a vicious circle of ever-rising levels of BAFF (B-cell-activating factor, also known as TNF ligand superfamily member 13B), increasing autoantibody production and worsening disease in some patients with SLE. They argue for combining B-cell depletion and BAFF blockade in patients with SLE who have post-rituximab flares characterized by high levels of antibodies to double-stranded DNA.