Connective tissue diseases
N-acetylcysteine is known to be effective for the short-term treatment of digital ulcers and Raynaud phenomenon in patients with systemic sclerosis; Rosato et al. have now shown that the agent also has beneficial long-term effects. In 50 consecutive patients treated for a median of 3 years, intravenous N-acetylcysteine therapy every 2 weeks led to a reduction in the numbers of digital ulcers and frequency of Raynaud attacks.
Belimumab combined with standard therapy is no better than standard therapy alone in the treatment of active systemic lupus erythematosus. In a 52-week randomized controlled trial, reductions in disease activity score and median time to disease flare were similar in the two treatment groups. Patients defined as “serologically active”, however, showed a considerably better response to combination therapy than standard therapy alone.
Wallace, D. J. et al. A phase II, randomized, double-blind, placebo-controlled, dose-ranging study of belimumab in patients with active systemic lupus erythematosus. Arthritis Rheum. 61, 1168–1178 (2009).
Pediatric rheumatology
A study from Italy suggests that serum osteopontin levels are a predictor of response to methotrexate therapy for juvenile idiopathic arthritis. Baseline levels of osteopontin were lower in patients who responded to methotrexate therapy than in non-responders. Although methotrexate considerably reduced osteopontin levels from baseline in both responders and non-responders, no significant associations were found between osteopontin levels and disease activity.
Rheumatoid arthritis
Investigators have suggested that increased expression of interleukin (IL)-7 and IL-7 receptor (IL-7Rα) in synovial tissue of patients with rheumatoid arthritis could lead to joint inflammation via activation of B cells, T cells and macrophages. Blockade with soluble human IL-7Rα ameliorated the receptor-mediated immune response in tissue samples, prompting the researchers to suggest that IL-7 could be a suitable therapeutic target in rheumatoid arthritis.
Hartgring, S. A. et al. Elevated expression of interleukin-7 receptor in inflamed joints mediates interleukin-7-induced immune activation in rheumatoid arthritis. Arthritis Rheum. 60, 2595–2605 (2009).
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In brief. Nat Rev Rheumatol 5, 592 (2009). https://doi.org/10.1038/nrrheum.2009.211
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DOI: https://doi.org/10.1038/nrrheum.2009.211