Volume 16 Issue 4, 15 April 2020

Newly discovered small-molecule TNF inhibitors serve as antagonists of pro-inflammatory TNF signalling by uniquely harnessing the conformational plasticity of trimeric TNF. The development of this approach could mark a resurgence of non-biologic modulators of clinically relevant protein–protein interactions in rheumatology.

Children and young people with rheumatic diseases face considerable challenges to their mental health, yet the research guiding prevention and intervention strategies is limited. A new research agenda provides an important step forward by highlighting important issues, but can these research priorities be addressed within the paediatric rheumatology health-care context?

Mechanical loading is an important factor in the development of tendon and ligament disorders. In this Review, the authors discuss the evidence for the known role of mechanical loading in tendinopathy and its potential role in inflammatory arthritis.

Raynaud phenomenon and digital ulcers are some of the most common and difficult to treat manifestations of systemic sclerosis. In this Review, the authors outline how to assess and treat these conditions, and also discuss unmet clinical needs.

The concept of autoinflammation has evolved to include multifactorial conditions and disorders with autoimmune and immunodeficiency components. An appreciation of the contributions of various molecular mechanisms and systems could improve our understanding and treatment of the systemic autoinflammatory diseases.

Glucocorticoids have been used to treat patients with rheumatic diseases for more than 70 years, but have been controversial owing to their safety record. Are we now entering an age when opinions about their use in rheumatology clinics are converging?