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Biologic agents targeting key proteins involved in bone homeostasis are revolutionizing the management of osteoporosis. New clinical data support the use of these novel therapies to rapidly increase bone mass and decrease the risk of fractures.
The heterogeneity of autoimmune rheumatic diseases, and their shared clinical and molecular features, makes classifying and diagnosing these diseases difficult and highlights the need for a new taxonomy. Reclassifying these diseases according to the underlying molecular mechanisms might lead to novel insights into disease mechanisms and enable better patient stratification.
Multiple scientific fields pertaining to inflammation, including the fields of cardiovascular, infection and cancer research, are increasingly contributing to our understanding of rheumatoid arthritis (RA). In 2017, such research has helped develop our understanding of RA comorbidity, the link between RA pathogenesis and infection, and the effects of new therapies.
Osteoarthritis research in 2017 provided new insights into the long-term effects of intra-articular glucocorticoids, and also led to the approval of a novel, longer-lasting glucocorticoid formulation. New drugs for the treatment of osteoarthritis also emerged this year, including a small-molecule inhibitor of the Wnt signalling pathway.
The rarity, severity and complexity of paediatric rheumatic diseases make progress in treating these diseases a challenge. In 2017, a new series of recommendations for treatment, studies that unravel the complexity of juvenile idiopathic arthritis and clinical trials that tackle sight-threatening uveitis have helped to improve paediatric care.
Tremendous progress has been made in the identification of rheumatoid arthritis (RA) risk factors in 2017. The results of epidemiological studies highlighted dietary and hormonal factors that are associated with slowing the transition from one preclinical phase of RA to another, potentially protecting individuals from developing RA.
A large number of patients with osteoporosis are not receiving appropriate treatment, due in part to concerns regarding drug safety. Great progress has been made to address this crisis in therapy in 2017, including highlighting the patients' views, developing new therapies and treatment strategies and addressing these safety concerns.
Preclinical studies suggest that the lymphatic system has a critical role in the pathogenesis and therapy of inflammatory-erosive arthritis. These findings, and complementary data from human studies, highlight the translational potential of assessing and modulating the lymphatic system in patients with chronic arthritis.
Osteoimmunology, the study of the complex interactions between bone and the immune system, is progressing rapidly as a field. In this Review, the authors highlight key advances in osteoimmunology and discuss how they relate to rheumatic diseases.
In this Review, the authors discuss the emerging evidence of the aetiology of Behçet's. They argue that geographical variation in prevalence, variation in disease expression and evidence of clinical subsets supports the notion that Behçet's is a syndrome rather than a disease.
