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‘Patient-centered’ research has traditionally meant that researchers and clinicians design trials for the benefit of patients. By contrast, patients today are central to study design and reporting outcomes, and new research agendas recognize that patients can point the way to research questions and how to address them.
Intra-articular therapies for knee osteoarthritis (OA) are causing excitement among clinicians and patients, but care should be taken when choosing which therapy to use. In this Review, Vangsness and colleagues critically appraise current and future intra-articular therapies for knee OA.
Despite the previous identification of genes involved in the treatment response to TNF inhibition in rheumatoid arthritis, no genetic biomarkers are currently used in clinical decision-making. Might the heterogeneous nature of the disease activity score, which is often used as the outcome measure in genetic studies, partly explain this gap?
The search for the identity of skeletal stem cells has reached a point at which skeletogenic cell populations with self-renewing capacity can be enriched and studied in detail. These advances provide new hope for skeletal regenerative medicine.
Gasdermin D is a pore-forming protein that can cause pyroptosis, a form of inflammatory cell death. New research indicates that the pores generated by gasdermin D can also promote the formation of neutrophil extracellular traps, potentially opening new therapeutic avenues for the treatment of inflammatory diseases.
Stromal cells of mesenchymal origin can help to sustain inflammation in the joint by various mechanisms; understanding these mechanisms could inform new therapeutic strategies and explain why joint inflammation persists in diseases of the joint such as arthritis, enthesopathy and tendinopathy.
Hydroxychloroquine is a front-line treatment for systemic lupus erythematosus and other rheumatic diseases, but can cause retinopathy. Improved detection techniques for the early stages (pre-symptomatic) of retinopathy has led to recommendations for reduced dosing, but more data on the efficacy of low-dose hydroxychloroquine are needed.
Nocebo effects can occur in patients with rheumatic and/or musculoskeletal diseases, and might result in suboptimal treatment outcomes or non-adherence. The consideration of nocebos is important in rheumatology practice and clinical trial design, including when switching patients to biosimilars.