News & Views in 2015

Could temporal changes in DNA methylation patterns of rheumatoid arthritis (RA) synoviocytes provide insights into the progression of the disease? A study comparing synoviocyte DNA methylation profiles in early and long-standing RA suggests this might be the case, with potential implications for understanding and perhaps modulating RA progression.

Emerging science characterizes lupus as a systemic spectrum disorder, rather than as multiple single-organ diseases. So is it time to capitalize on this progress and begin evaluating treatment options on the basis of physiologic mechanisms instead of organ involvement?

Compliance with reporting clinical trial results varies across research fields and types of sponsors. In rheumatology, most industry-funded trials of biologic agents are currently reported promptly. Optimizing clinical research will nevertheless require steps beyond deposition of summary results, including making raw data and protocols available, and assuring independence of the research agenda.

In a phase II–III trial, a novel antibody targeting IL-6 receptor α (IL-6Rα), sarilumab, conferred clinical, functional and structural benefits in rheumatoid arthritis. These results, though, seem quite similar to those for tocilizumab, the existing anti-IL-6Rα antibody, as well as for other agents currently in development that target this same pathway.

As patents expire for biologic reference products (innovators), biosimilar agents are joining the treatment landscape in rheumatology. Release of an ACR position statement on biosimilars prompts US rheumatologists to focus on issues relating to the clinical use of these agents and can also be helpful for rheumatologists in other regions where biosimilar agent regulatory processes are not yet fully implemented.

Is the risk of hospitalization and death due to serious infections on the rise in patients with systemic lupus erythematosus (SLE)? A population-based study provides insights into these trends and highlights the need for safe, effective treatment strategies in SLE.

Anti-citrullinated protein antibodies are a distinctive feature of a subset of patients with rheumatoid arthritis (RA). A new report investigates how lung inflammation in patients with chronic obstructive pulmonary disease affects protein citrullination, providing an additional piece of information on the potential link between airway inflammation and RA.

With advances in stem cell techniques for the bioengineering and regeneration of musculoskeletal tissues comes added complexity in our understanding of stem cell biology. How will the recent discovery of a novel stem cell subset, termed osteochondroreticular stem cells, contribute to progression in the field?

The sensitivity of the long-awaited SLICC classification criteria for systemic lupus erythematosus (SLE) has now been examined in a cross-sectional observational study. Will the new criteria enable advances in the management of SLE?

Examination of biopsy-obtained salivary gland tissue provides valuable insights for the diagnosis, classification and treatment of patients with primary Sjögren syndrome. Could the study of biomarkers present in saliva provide a noninvasive alternative?

Given the established role of 90 kDa ribosomal S6 kinases (Rsk) in oncogenesis, and the promise of new Rsk-blocking cancer treatments, it is perhaps surprising that Rsk2-mediated inhibition of hyperplasia has now been demonstrated to occur in the arthritic synovium. Does this functional duality make Rsk2 a risky target for the treatment of rheumatoid arthritis?

Recommendations for the use of valgus bracing for knee osteoarthritis are inconsistent. Two new complementary systematic reviews and meta-analyses—concentrating on biomechanical factors and clinical effects, respectively—raise practical issues and suggest future research directions.