Connective tissue diseases

Tadalafil is no more effective than placebo in the treatment of Raynaud phenomenon secondary to systemic sclerosis. In a prospective study, 39 women were randomly assigned to receive a daily oral dose of 20 mg tadalafil or placebo. After 4 weeks, neither the frequency nor duration of Raynaud phenomenon episodes differed between the two treatment groups, and no difference was observed in the severity of symptoms.

Schiopu, E. et al. Randomized placebo-controlled crossover trial of tadalafil in Raynaud phenomenon secondary to systemic sclerosis. J. Rheumatol. 36, 2264–2268 (2009).

Bedside imaging of ultrasound lung comets, echographic signs of interstitial lung fibrosis, could have diagnostic and prognostic value in the assessment of patients with systemic sclerosis. In 33 consecutive patients, the presence of lung comets correlated positively with high-resolution CT assessment, the gold standard for detecting pulmonary fibrosis. In addition, ultrasound lung comets were found to occur more often in patients with the diffuse rather than the limited form of systemic sclerosis.

Gargani, L. et al. Ultrasound lung comets in systemic sclerosis: a chest sonography hallmark of pulmonary interstitial fibrosis. Rheumatology (Oxford) 48, 1382–1387 (2009).

Inflammatory myopathies

A study from Tokyo, Japan has shown that the orally administered synthetic retinoid Am80 has an inhibitory effect on experimental autoimmune myositis in mice. In addition to its effects on cytokine and chemokine production, the compound could also influence T-cell phenotype development by promoting type 1 and type 2 T helper differentiation and suppressing the development of type 17 T helper cells.

Ohyanagi, N. et al. Retinoid ameliorates experimental autoimmune myositis, with modulation of Th cell differentiation and antibody production in vivo. Arthritis Rheum. 60, 3118–3127 (2009).

Rheumatoid arthritis

In a prospective, 4-month study of 66 patients with rheumatoid arthritis, ultrasound evaluation was at least as relevant as clinical examination in the assessment of clinical change in synovitis. Further studies are needed to optimize ultrasound scoring systems in order to facilitate the use of ultrasonography in research and in clinical practice.

Dougados, M. et al. Evaluation of several ultrasonography scoring systems of synovitis and comparison to clinical examination: results from a prospective multi-center study of rheumatoid arthritis. Ann. Rheum. Dis. doi:10.1136/ard.2009.115493