Volume 2 Issue 2, February 2006

Trials investigating T-cell targeted therapies for rheumatoid arthritis have been of limited success. This Viewpoint considers whether or not the hypothesis that T cells are involved in the pathogenesis of rheumatoid arthritis is true and, if so, why trials so far have not led to an applicable therapy.

Patients with osteoarthritis often turn to complementary or alternative medicines as a substitute to, or to supplement, conventional therapies. This Review discusses the best available evidence for or against these approaches as treatments for osteoarthritis and highlights areas that warrant further investigation in large-scale randomized clinical trials.

Catastrophic antiphospholipid syndrome, a severe form of antiphospholipid syndrome, is associated with a high mortality rate; approximately 50% of patients die from thrombotic diathesis. As discussed in this Review, efforts to facilitate early diagnosis, institute effective treatments in a timely manner, and to better understand the causes of this extreme condition are needed to improve patient outcome.

The pathogenesis of pain in patients with fibromyalgia syndrome is complex and incompletely understood. In this Review, Roland Staud and Miguel E Rodriguez discuss the abnormalities of pain processing that occur in these patients, focusing on the role of deep-tissue nociception, peripheral and central pain processing, temporal summation of pain (or wind-up) and central sensitization.

Patients with autoimmune rheumatic diseases are at a high risk of developing premature atherosclerosis and subsequent cardiovascular disease. This Review discusses the role of the immune system in this process and highlights potential ways in which the development of atherosclerosis can be immunomodulated in experimental models.