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EULAR’s 2023 updated recommendations for the non-pharmacological treatment of hip and knee osteoarthritis reiterates and confirms, in an abbreviated form, what we have known for more than a decade. Unfortunately, the abbreviated format of the updated recommendations lacks specificity and clinical usefulness. More detailed guidance could have facilitated wider uptake and improved care.
Characteristic patterns of joint involvement exist in different forms of arthritis. Research now indicates that epigenetic programming of synovial fibroblasts diversifies their response to inflammatory cascades, leading to this anatomical variation in arthritis and its response to treatment.
In 2006, a linear immunological continuum of autoinflammatory and autoimmune disorders ranging from monogenic diseases of innate immunity at one end to monogenic diseases of adaptive immunity at the other end was proposed to classify these conditions. Deep immunophenotyping has now revealed a cell-based nosology of these disorders.
The World Health Organization (WHO) has published new guidelines for the non-surgical management of chronic primary low back pain in adults in primary and community care settings. Although the guidelines are commendable, they lack guidance on when to suspect and how to avoid missing important secondary causes of back pain.
New findings suggest that current cell therapy approaches are not superior to a simple corticosteroid injection for the treatment of osteoarthritis, calling into question the role of existing cell therapies and highlighting the need for further research and development in this field.
Re-establishing tolerance to autoantigens is an important aim for the treatment of rheumatoid arthritis (RA). Immunization of HLA-DR4 transgenic mice with citrullinated self-antigens can induce immune tolerance, which suggests that such antigens could have a therapeutic role in anti-citrullinated peptide antibody-positive RA.
The identification of novel risk variants in the largest genome-wide association study of Raynaud phenomenon to date provides insights into the pathophysiology of the condition, including the potential role for α2A-adrenoceptors, and suggests opportunities for drug repurposing.
