News & Views

Standard therapy for vasculitis associated with antineutrophil cytoplasmic antibodies can achieve high rates of remission, but with the risk of serious toxic effects. The results of a placebo-controlled trial in patients with severe disease suggest that an effective alternative could be on the horizon.

Minimizing the potential adverse effects of clinical investigators' financial conflicts of interest involves, in part, determining how much of an investigator's 'business' should be disclosed to participants in research studies. What should be disclosed and why? How will we know if disclosure matters?

To date, understanding of the molecular mechanisms of bone metabolism has centered on three tumor necrosis factor family members—RANK, its ligand RANKL and its decoy receptor osteoprotegrin. This view should now be modified, however, to incorporate the role of interferon regulatory factor-8.

Interactions between HLA and PTPN22 genotypes and smoking have been implicated in overall susceptibility to rheumatoid arthritis as well as the incidence of particular disease phenotypes in case–control and case-only studies. As recent epidemiological evidence shows, deciphering these interactions demands consideration of the analytical approach used.

Since the introduction of new biologic agents and intensive treatment strategies that aim to tightly control disease activity, clinical remission has become a realistic target in patients with rheumatoid arthritis. Once patients are in continuous remission, however, is it realistic to consider withdrawing DMARD therapy?

Several lines of evidence both from experimental models and from clinical studies reveal that TNF-like ligand 1A (TL1A) and its interaction with death receptor 3 (DR3) is critically involved in the pathogenesis of rheumatoid arthritis and other autoimmune diseases.

What is the psychological and clinical effectiveness of a home-based emotional disclosure intervention? Results from a randomized, controlled trial of such an intervention in patients with rheumatoid arthritis could have implications for the future of therapeutic research and clinical practice.

Septic arthritis kills 10–15% of patients, despite advances in medical treatment over the past 50 years. Is it time to revisit the question of whether, in addition to medical treatment, joint surgery is necessary?

Antimalarial agents have long been used in the treatment of autoimmune diseases, despite uncertainty regarding the exact mechanisms underlying their various effects. Growing evidence that these drugs offer protection from major infections could stimulate more research into these mechanisms, with possible implications for therapy.

Surgery is the current mainstay of treatment for Dupuytren disease but is associated with potentially serious complications and a high rate of recurrence. A phase III study of enzymatic fasciotomy promises advances towards effective nonsurgical treatment of this debilitating disorder.

Researchers have identified a new molecular pathway for the regulation of bone and energy metabolism that challenges the conventional view of the role of leptin in bone turnover.

Two randomized controlled trials have shown no significant differences in outcome between vertebroplasty and a sham procedure in patients with back pain and vertebral fracture. What conclusions can be drawn from these results?

New research shows that intensive bisphosphonate therapy for Paget disease of bone has no beneficial effect on quality of life, bone pain or clinical complications compared with symptomatic management. What are the implications of these findings on the management of patients with Paget disease?

Adipocytokines are usually regarded as signaling molecules that originate from and act within the adipose tissue. However, recent data show that adipocytokines, especially adiponectin, exert various functions throughout the organism that are neither unambiguously protective nor solely harmful.

In the late 1990s, bone cell biologists predicted inhibition of RANKL as an important therapeutic target for osteoporosis. The theory has now been confirmed by two studies showing that denosumab reduces fracture risk. This success for translational research should be tempered by awareness of the need for long-term monitoring for adverse effects.

Insight into the immunopathogenesis of crystal-induced inflammation has opened the door to a new approach to therapy. Could interleukin-1 antagonists be the answer to managing acute gout?

Transcriptomics and proteomics are transforming our understanding of juvenile idiopathic arthritis by revealing molecular signatures associated with the various clinical classifications. The challenge now is to find biomarkers that will predict disease course and response to medication in order to improve outcomes for children with arthritis.

Golimumab effectively reduces the signs and symptoms of active rheumatoid arthritis in patients who have previously failed treatment with at least one tumor necrosis factor inhibitor. Is it now time to develop strategies for sequential drug administration?

Randomized controlled trials investigating non-pharmacological therapies for hand osteoarthritis are rare. One such study now suggests that neoprene splints could be effective for the treatment of base-of-thumb osteoarthritis—but some questions remain unanswered.

A rare but often fatal viral disease has been reported in a number of patients treated with rituximab, but how the risk of this complication should affect prescription practices demands consideration of several important factors.