News & Views

Biologic therapies that target interleukin (IL)-1 are known to dramatically improve symptoms of a group of rare, heritable chronic inflammatory diseases. The results of a phase III trial confirm the place of canakinumab in the treatment arsenal for these disorders.

Why are female athletes more susceptible to knee ligament injuries than male athletes performing the same activities? Several theories have been put forward to explain this phenomenon.

The results of two new studies suggest mutations in the gene encoding the interleukin (IL)-1 receptor antagonist (IL-1Ra) are responsible for a spectrum of childhood inflammatory disorders characterized by an imbalance in IL-1 expression. What implications do these intriguing results have for the diagnosis and management of IL1-driven inflammatory disorders?

New research reports that primary human dermal fibroblasts seeded into a three-dimensional biodegradable matrix can differentiate in vitro into osteoblasts and chondrocytes, and form three-dimensional bone-like and cartilage-like constructs, respectively. Is skeletal tissue engineering from skin biopsy tissue on the horizon?

The latest guidelines from the American Pain Society (APS) provide a comprehensive analysis of the evidence on the use of interdisciplinary rehabilitation and surgical and interventional procedures for the treatment and diagnosis of chronic low back pain. But will they have any impact on clinical practice?

What is the relationship between genetic and environmental risk factors in predisposing for rheumatoid arthritis (RA)? A new study provides more details on the interaction between the HLA DRB1 shared epitope (SE) alleles and smoking in conferring the risk of autoantibody-positive RA.

Medications that inhibit gastric acid secretion are standard co-therapy with NSAIDs, but evidence is emerging of a link between prolonged use of these agents and an increased risk of hip fracture.

Clinical tests of the novel small-molecule inhibitor of p38α MAPK, VX-702, have resulted in an all-too-familiar outcome: modest clinical efficacy and transient inhibition of inflammatory markers. Why have p38α inhibitors failed, and what can we learn about the regulation of signal transduction pathways in inflammatory arthritis?

The degree to which the elevated risk of malignant lymphomas in patients with rheumatoid arthritis (RA) is related to disease activity or to therapy is uncertain. Evidence is mounting in support of a strategy of more-intensive cancer screening in these patients.

In April 2009, efalizumab was withdrawn from the market for the treatment of psoriasis after reports emerged of an association between long-term therapy and the development of progressive multifocal leukoencephalopathy (PML). This event highlights an urgent need for greater awareness and research into the screening, diagnosis and treatment of this potentially fatal disease in patients undergoing immunosuppressive therapy for chronic inflammatory disorders.

Molecules involved in developmental signaling pathways have emerged as therapeutic targets for various rheumatic diseases. New research sheds light on the consequences of interfering with these processes.

The choice of optimum second-line DMARDs for patients with rheumatoid arthritis is fraught with challenges. The implementation of evidence-based guidelines designed to inform clinicians' decisions requires careful consideration of several important issues.

As of May 1, 2009, PubMed listed approximately 30,000 citations on the topic of vitamin D in humans, highlighting the medical community's avid interest in this field. Two articles published in the Archives of Internal Medicine diverge with previous reports on the prevalence of hypovitaminosis D and the capability of vitamin D to reduce fractures.

Several high-profile institutions are now following the trend of limiting doctors' ties to industry by way of implementing stringent new guidelines. But do the recommendations go far enough?

According to a study by Chevalier and colleagues, a single intra-articular injection of anakinra is no more effective than placebo for treating the symptoms of knee osteoarthritis (OA). This result, however, should not deter future investigations of this agent for the treatment of patients with symptomatic knee OA.

Consistent with evidence from trials in osteoarthritis of the knee, the results of a randomized controlled trial demonstrate that, for symptomatic hip osteoarthritis, a single intra-articular injection of hyaluronic acid is no better than placebo at alleviating pain.

Despite a lack of definitive evidence supporting their efficacy, nonselective immunosuppressive drugs are frequently prescribed for patients with systemic sclerosis (SSc). An analysis of data collected for a German registry provides a review of their experience with the use of these medications.

Several studies have shown that tumor necrosis factor (TNF) inhibitors are associated with an overall increased risk of serious infections compared with standard immunosuppressive regimens in patients with rheumatoid arthritis (RA). A study by Strangfeld et al. adds specificity by showing a moderately increased risk of herpes zoster in patients receiving anti-TNF antibody treatment, and raises the question of whether live zoster vaccines should be utilized in this patient group.

The link between exposure to exogenous estrogen and the incidence of systemic lupus erythematosus is controversial, but new data suggest that the use of combined oral contraceptives could increase the risk of developing the disease.

Many people with chronic rheumatic diseases choose to use complementary and alternative therapies on the basis of information from unreliable sources. Does a report from a UK-based arthritis charity meet the need for rigorous, evidence-based recommendations for the public and for health-care providers?