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The establishment of new benchmarks for treatment outcomes promises to drive great advances in rheumatoid arthritis therapy, but data on 'real life' experience with biologic therapy demonstrate that geographic location influences the stage of disease at which these agents are initiated.
Several new recommendations for the vaccination of adults with autoimmune inflammatory diseases could represent an important step forward in the prevention of infections in these high-risk patients.
OA is not a disease in short supply of phenotypic definitions. Indeed, numerous classification options complicate the design of genetic studies seeking associations within the obscuring array of heterogeneity. New recommendations offer some progress toward clarifying OA definitions, but much-needed guidelines are wanting.
Seemingly contrasting genetic backgrounds in anti-citrullinated-protein antibody (ACPA)-positive and ACPA-negative rheumatoid arthritis (RA) support the notion that these are in fact two distinct disease subsets, with different underlying pathogenesis, that might need tailored treatment strategies.
Despite greatly advancing the therapy of rheumatoid arthritis, the clinical use of biologic agents leaves unanswered a number of important questions. As discussed in this Review, ongoing efforts to improve our understanding of these issues should aim to establish the optimum use of biologic therapy, with the ultimate goal of achieving the best possible therapeutic outcomes in an individual patient.
Mounting evidence indicates that cognitive and emotional processes are important determinates of how individuals with rheumatic disorders experience pain. Depression and catastrophizing, in particular, shape pain responses and pain outcomes through several distinct pathways, and could represent targets for improving and individualizing therapy.
In this Review, the authors describe the marked differences in clinical presentation, prognosis, disease assessment and treatment options that exist between pediatric and adult-onset systemic lupus erythematosus, which highlight our need to find new ways of improving disease control in affected children.
The use of genetically modified animal models has helped to identify the crucial factors involved in the differentiation and function of osteoclasts. This Review discusses the main observations in osteoclast biology derived from animal models, and outlines the osteoclast-targeted therapies that have developed from these studies.
Despite preclinical evidence of the safety and efficacy of gene therapy for arthritis, few clinical trials have been undertaken. What are the constraints on the development of this therapeutic strategy, and are these barriers likely to be overcome?
