News & Views

Large-scale genetic studies have highlighted the retinoic acid pathway as a contender in the pathogenesis of hand osteoarthritis. Functional studies are offering further insights into the role of retinoic acid that might translate into future therapies.

A variety of biologic DMARDs now exist for the treatment of rheumatoid arthritis, but we don’t really know how these drugs function in vivo. Can time-lapse intravital imaging distinguish the modes of action of DMARDs by comparing response to joint destruction in mouse models of arthritis?

Some patients with psoriatic arthritis are refractive to one biologic therapy but not to others, and a strategy for selecting the right therapy for each patient is needed. The findings of a new study highlight the potential benefit of stratifying patients by their immunophenotype to select the optimal biologic to use.

A new epidemiological study suggests that only half of patients with hyperuricaemia will go on to develop gout. If ‘the glass is only half-full’, then is hyperuricaemia the most important risk factor for the development of gout?

Poor medication adherence and depression interfere with the management of patients with systemic lupus erythematosus, especially adolescent and young adult patients. For patients for whom clinic visits and education programs fail to improve adherence, novel social media-based interventions are demonstrating the ability to increase patient agency, self-efficacy, and adherence.

As the diagnosis and management of systemic lupus erythematosus (SLE) can be challenging, reclassification of SLE on the basis of biomarker data provides novel insights. Definitions of antinuclear antibodies and attention to SMAARTT criteria (specificity – sensitivity, measurable, actionable, added value, realistic, titres, timely) are needed to translate these new analytical frameworks into real-time clinical use.

The largest study to date on the genetics of hip and knee osteoarthritis (OA) has yielded new associations with genes encoding a cytokine, a kinase and a transcriptional repressor, as well as genetic correlations with other diseases. Can these clues help to unravel details of the pathogenesis of OA?

Pain management can be a difficult problem for patients with rheumatoid arthritis (RA), some of whom can experience pain similar to that reported by patients with fibromyalgia. Now, advanced imaging techniques are revealing neurobiological alterations in patients with RA that mirror those seen in fibromyalgia, hinting at new treatment possibilities.

The success of intravenous immunoglobulin immunotherapy in autoimmune diseases has inspired the development of novel Fc-based therapeutics, in particular, multimerized polyvalent Fc molecules. A new study reports that a recombinant IgG1 Fc hexamer alleviates acute and chronic autoimmune diseases in mice.

The application of new technologies including RNA sequencing and machine learning to the analysis of synovial tissue is yielding new insights into the pathology of rheumatoid arthritis, with potential implications for the clinical management of the disease.

Patients with psoriatic arthritis and other inflammatory joint diseases have a high risk of cardiovascular disease (CVD), but use relatively little preventive medication such as antihypertensive and lipid lowering agents. An unmet need exists for the optimization of CVD prevention in this high-risk patient population.

Interstitial lung disease (ILD) is a major cause of death and disability in patients with polymyositis or dermatomyositis. To begin to improve patient outcomes, the clinical, demographic and therapeutic factors associated with poor prognosis for patients with ILD associated with polymyositis or dermatomyositis need to be identified.

What causes muscle fibre necrosis in necrotizing myopathy? The authors of a new study propose that specific autoantibodies contribute to disease via immune-mediated processes; but given that these processes also occur in muscular dystrophies, how likely is that these antibodies trigger muscle fibre necrosis?

The newly published 5-year outcomes of the IMPROVED trial demonstrate the feasibility of achieving long-term drug-free remission in early rheumatoid arthritis (RA). These findings raise the bar and support the use of a remission induction and maintenance approach, particularly in patients presenting with early joint inflammation consistent with early RA.

A great deal of interest exists in the use of regulatory T cells for therapeutic purposes in autoimmune diseases such as rheumatoid arthritis. Two new studies highlight possible approaches to achieve this aim, but the jury is still out on whether these will become effective therapies.

Autologous haematopoietic stem cell transplantation (HSCT) has proved efficacious in treating patients with systemic sclerosis, but different regimens have different associated toxicities and different effects on lung function. Through comparison of different clinical trials, we can learn how to improve the safety of HSCT.

A detailed report on the involvement of skin in vasculitis enriches existing disease definitions and nomenclature, and could improve the diagnosis of these manifestations. The exercise also emphasizes the need for collaboration across different medical specialties in the study of vasculitis.

Bisphosphonates have been proposed as a potential disease-modifying treatment for osteoarthritis (OA); however, it is as yet unclear if this treatment is effective. Evidence from a new meta-analysis raises the question of whether bisphosphonates can reduce damage in OA.

A new publication by the GRAPPA–OMERACT group provides recommendations and a useful framework for physicians on the use of composite measures and treatment targets in psoriatic arthritis. However, these recommendations highlight the need for more research in order to improve patient care and health-related quality of life.

New evidence strengthens the hypothesis that exposure to trauma and the associated physiological responses contribute to the development of autoimmune diseases, including systemic lupus erythematosus.