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  • Glucocorticoids are common medications that are used in research trials and clinical practice. Measuring the toxicity of glucocorticoids in children is complicated by various factors such as age and growth. A standardized tool could help to record these toxicities across different specialities in a systematic manner.

    • Charlotte King
    • Daniel B. Hawcutt
    News & Views
  • New research reinforces the fact that most recommendations in rheumatology are not informed by comparative efficacy randomized controlled trials. Performing these studies is time and resource intensive. Policies and funding to perform these studies in a timely and resource constraint manner are essential.

    • Raveendhara R. Bannuru
    News & Views
  • Often viewed as merely an inconsequential episode of acute joint pain, gout flare has also been associated with an increased risk of acute myocardial infarction and stroke. New findings suggest the risk is highest within the first 60 days of gout flare, and could be influenced by flare treatment.

    • Hyon K. Choi
    • Natalie McCormick
    News & Views
  • New research shows that TNF can directly induce osteoclastogenesis from transforming growth factor-β (TGFβ)-primed macrophages and that knockout of TGFβ signalling limits TNF-induced arthritic bone erosion in mice, suggesting that TGFβ inhibition could enhance the effect of anti-TNF therapy in rheumatoid arthritis.

    • Zhenqiang Yao
    • Brendan F. Boyce
    News & Views
  • Transitional care in rheumatology has been debated for over three decades and yet unmet needs of young people are still being reported. Why the slow progress? Perhaps we need to stop talking about transitional care in rheumatology and talk more about developmentally appropriate health care for young people with rheumatic conditions.

    • Janet E. McDonagh
    • Albert Farre
    News & Views
  • Multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease are both hyperinflammatory disorders associated with infectious diseases, but are they distinct syndromes or do they exist along a continuum? A comparison of the host immune response in these illnesses provides surprising new insights.

    • Paul Tsoukas
    • Rae S. M. Yeung
    News & Views
  • Lack of understanding of the immunology of sarcoidosis has limited therapeutic progress. However, evidence from a small open-label trial suggests that treatment with the Janus kinase inhibitor tofacitinib can improve sarcoidosis symptoms, predominantly by inhibiting type 1 immunity.

    • Nadera J. Sweiss
    • Robert Baughman
    News & Views
  • In patients with autoimmune rheumatic disease, methotrexate therapy has been associated with poor immune response to vaccines, including those intended to provide protection against COVID-19. Emerging evidence supports the practice of temporarily discontinuing this treatment in order to improve immunogenicity.

    • Ana C. Medeiros-Ribeiro
    • Nadia E. Aikawa
    News & Views
  • Although the multitude of pathways involved in the pathogenesis of systemic lupus erythematosus (SLE) seem to be interconnected, each predominates in only a fraction of patients. This complexity means that many agents tested in SLE clinical trials — now including iberdomide — produce only a small clinical benefit.

    • Afroditi Boulougoura
    • George C. Tsokos
    News & Views
  • Do you inform patients about risks and chances of success associated with different choices when treatment needs to be changed? This approach takes time and requires patient health literacy. Results from a discrete-choice experiment in scleroderma lung disease add to the debate on shared decision-making.

    • Janet E. Pope
    News & Views
  • New research reveals that outcomes for patients with rheumatoid arthritis are affected less by pre-existing comorbid conditions than by socioeconomic factors. Future research should address the mechanisms of this relationship and develop holistic treatment approaches that reduce disparities attributed to socioeconomic status.

    • Zara Izadi
    • Gabriela Schmajuk
    News & Views
  • The new ACR guideline for the treatment of juvenile idiopathic arthritis provides an update on several important topics, including management of oligoarthritis, temporomandibular joint arthritis and systemic-onset arthritis. Overall, the new guideline reflects changes in practice, but also highlights a concerning lack of high-quality evidence.

    • Roberta Naddei
    • Angelo Ravelli
    News & Views
  • New classification criteria for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis endorsed by ACR and EULAR reflect important developments in the field since the 1990 criteria were published, including bringing ANCA testing to the fore.

    • Matthew J. Koster
    • Kenneth J. Warrington
    News & Views
  • New evidence implicates necroptosis in muscle fibre damage in idiopathic inflammatory myopathies, but is it too soon to suggest that interfering with this cell-death pathway could offer a novel therapeutic strategy?

    • Kanneboyina Nagaraju
    • Melissa Morales
    News & Views
  • New EULAR recommendations offer useful guidance for improving cardiovascular health in patients with rheumatic and musculoskeletal disease. However, an interdisciplinary model of care is crucial to the optimal management of cardiovascular risk in these patients.

    • Lihi Eder
    • Paula Harvey
    News & Views
  • Undifferentiated arthritis (UA) was redefined by the introduction of the 2010 rheumatoid arthritis (RA) classification criteria. But UA is more than just not having RA — it is about selecting the right patients for DMARD treatment even before diagnosis, and about protecting those with self-limiting disease from potential drug toxicity.

    • Daniel Aletaha
    News & Views
  • The COVID-19 pandemic has caused a rapid transition towards telemedicine, raising concerns about assessment accuracy, medical-relationship building and potential inequalities between patient groups. For some rheumatology patients, telemedicine is convenient and acceptable, but careful selection and choice are important.

    • Martin Krusche
    News & Views
  • New research reports that men with inflammatory arthritis experience an impact on sexual health beyond erectile dysfunction, affecting their emotional, mental, and social health. Training to empower health professionals to have conversations about sex could improve support for people with rheumatic diseases.

    • Caroline A. Flurey
    News & Views
  • Smoking during adulthood is a known risk factor for seropositive rheumatoid arthritis (RA) but how exposure to passive smoking affects RA risk is uncertain. New data from the Nurses’ Health Study on passive smoking over a lifetime suggest childhood exposure could be an important factor for future RA development.

    • Lars Klareskog
    News & Views
  • The results of several retrospective studies have reported that systemic treatment in patients with psoriasis reduces the risk of incident psoriatic arthritis (PsA). Although encouraging from a prevention perspective, such studies are limited in their ability to provide a conclusive understanding of PsA risk, preventing a clear picture from emerging.

    • Joseph F. Merola
    • Alexis Ogdie
    News & Views