Rheumatoid arthritis

Using data from the large Danish DANBIO registry, Hetland et al. have shown that of the three major tumor necrosis factor inhibitors used to treat rheumatoid arthritis, infliximab was associated with the lowest rates of response, disease remission and adherence (n = 2,326). By contrast, patients taking adalimumab had the highest rates of remission and response, and etanercept users showed the highest rates of adherence.

Surgery

A small study now published in the journal Arthroscopy suggests that arthroscopic debridement combined with synovectomy is an effective treatment for stage I or stage II basal joint arthritis. At 12-month follow-up, patients who had undergone the combination procedure (n = 23) reported considerable improvements in pain and function scores, as measured on a visual analog scale and the Disabilities of the Arm, Shoulder and Hand index, respectively, as well as in pinch strength, compared with matched controls who had received conventional nonoperative therapy (n = 21).

Pain

A semi-intensive multidisciplinary outpatient program involving occupational therapy, psychotherapy, physical reconditioning and patient education has been shown to markedly reduce chronic low back pain in 262 patients in Belgium. At the end of the program, which comprised 36 2-hour sessions, pain intensity, functional impairment, and kinesiophobia decreased by an average of 44%, 40% and 11%, respectively, and mobility improved by 8%, compared with baseline. In addition, back-sparing technique improved by 95%.

Imaging

Investigators from the UK suggest that dermoscopy is reliable for identifying nailfold capillary abnormalities, which can be predictive of underlying connective tissue disease. Moore et al. suggest that for rheumatologists without access to wide-field or video capillaroscopy, the technique could be a useful alternative that would require little training.