News & Views

Fibroblast-like synoviocytes isolated from the knee and hip joints of patients with rheumatoid arthritis or osteoarthritis have now been shown to have site-specific DNA methylation signatures. Although preliminary, the data point towards a new view of joint involvement in arthritis.

Interstitial lung disease is one of the most important causes of mortality in patients with polymyositis or dermatomyositis. Understanding the risk factors for development and progression of interstitial lung disease is crucial to improving clinical outcomes.

Obesity in rheumatoid arthritis is characterized by high disease activity and low rates of remission; paradoxically, it is also associated with reduced radiographic progression. So, is intentional weight loss beneficial or detrimental to articular outcomes?

Type I interferons contribute to the pathogenesis of several autoimmune diseases, with each interferon being preferentially produced in different settings by different cells. Could knowing which one is predominant in a given disease — or patient — lead to better therapies?

Radiographic joint-space width is the standard structural outcome for trials in knee osteoarthritis (OA), but MRI provides comprehensive 3D insights into the multi-tissue pathology of OA and could provide a superior means of monitoring disease progression and response to treatment. A new study highlights bone as an imaging biomarker.

Glucocorticoids are cost-effective drugs that exert strong anti-inflammatory and immunosuppressive effects. However, there is increasing awareness of their potential adverse effects. Although Cushingoid appearance and weight gain have been known for decades, modern measurements of body composition now enable detailed insights into glucocorticoid-induced changes in fat mass and redistribution.

Statin treatment is a cornerstone in the prevention of cardiovascular disease, but questions remain regarding its effects in patients with ankylosing spondylitis. Is there enough evidence supporting the use of statins in these patients?

Autoantibodies against end products of lipid peroxidation have unexpected effects on atherosclerosis in systemic lupus erythematosus (SLE). The discovery of their effects could lead to new theories about the role of the adaptive immune system in SLE.

Cases of systemic lupus erythematosus with onset during childhood seem to be more severe than adult-onset disease, possibly because of genetic influences. But is more-detailed information about the molecular heterogeneity of the disease needed in order to tailor treatments and improve prognosis?

Diagnostic algorithms for axial spondyloarthritis (SpA), and classification criteria for use in clinical trials, are being developed and refined. But can axial SpA be ruled out in young patients with only one clinical feature of SpA prior to imaging studies and HLA-B27 testing?

Type I interferon (IFN) is an attractive therapeutic target in systemic lupus erythematosus (SLE), a notion bolstered by the positive results of a recent clinical trial of the anti-IFN antibody sifalimumab in patients with SLE. Interestingly, sifalimumab worked best in patients with high expression of IFN-induced genes, supporting the idea that subgroups of patients might be targeted specifically.

Non-radiographic axial spondyloarthritis (nr-axSpA) and radiographic axial spondyloarthritis (r-axSpA) are considered to be different spectra of the same disease. Accumulating data suggest a low transition rate from nr-axSpA to r-axSpA in patients with early disease and identify inflammation, smoking and HLA-B27 positivity as factors associated with transition.

Although paracetamol is widely used and recommended for the management of pain in osteoarthritis, accumulating data indicate that it lacks efficacy and is associated with severe adverse effects. A new meta-analysis adds further weight to calls for clinical practice and treatment guidelines to be updated to reflect the evidence.

Clinical trial data suggest the IL-6-targeted drug clazakizumab ameliorates the symptoms of psoriatic arthritis (PsA), in particular the musculoskeletal manifestations of the disease. Could this new treatment hold promise for a certain subgroup of patients with PsA?

Cardiovascular events are a major cause of death in patients with rheumatoid arthritis (RA). Recent data suggest that TNF inhibition can reduce both disease activity and the risk of acute coronary syndrome, adding to our knowledge of how RA therapies modify cardiovascular risk.

Familial Mediterranean fever is a rare disorder but is usually easy to manage using colchicine. The publication of a severity score could serve as a useful reminder to rheumatologists about this disease and the difficulties in assessing its severity.

New guidance issued by NICE in the UK addresses issues of when and for whom to introduce biologic drugs, including biosimilars, in the treatment of rheumatoid arthritis. Could differences between these recommendations and those of national societies have implications for patient care?

The selective utilization of IRAK kinases, which are thought to be recruited to MyD88 to form the 'Myddosome', has been shown to differ substantially in mouse and human cells. This finding has important implications for the development of therapeutics for inflammatory and autoimmune disorders associated with Toll-like receptors.

Medical management of women with rheumatic diseases during pregnancy is challenging owing to incomplete information regarding medication safety. The British Society for Rheumatology and the British Health Professionals in Rheumatology committee published consensus guidelines that provide a good first step towards narrowing the knowledge gap in this important field.

Mitochondria are the powerhouses of the cell, providing energy through oxidative respiration. Possibly owing to their similarities with bacteria, however, mitochondria extruded from cells promote inflammation. New research demonstrates that in systemic lupus erythematosus, mitochondrial respiration is critical in neutrophil extracellular trap formation, and that mitochondria released by neutrophils induce inflammatory cytokine production.