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2013 has witnessed the maturation of imaging science with rheumatology research, in part due to large, public databases. Using imaging in osteoarthritis (OA) as an example, breakthroughs include further elucidation of the relationship between obesity and OA, and identification of the importance of bone and meniscus shape in OA development.
Clinical, basic and translational research in systemic lupus erythematosus are fast-moving fields. 2013 has seen the publication of some potentially landmark papers, which not only explore the potential of novel agents but also glean new insights from past trials.
In 2013, much progress has occurred in gout research. Imaging continues to help elucidate aspects of pathophysiology and now suggests that healing of erosions could occur when urate levels are reduced dramatically. New genetic loci associated with hyperuricaemia have been identified and management strategies for prophylaxis of gout flares continue to evolve.
A number of microRNAs have been implicated in the pathogenesis of various rheumatic diseases, and evidence in support of the therapeutic potential of microRNA-based strategies for these conditions is growing, as demonstrated by several new findings published in 2012.
Tissue engineering and regenerative medicine have advanced rapidly towards the development of therapeutic solutions for musculoskeletal disorders. In 2012, breakthroughs have been made in the guidance of adult stem cell homing, the tissue regenerative activity of stem-cell-derived extracellular matrix has been tested, and novel, mechanically superior biomaterials have been fabricated.
Developments in our knowledge of the aetiology and pathogenesis of rheumatoid arthritis continued apace in 2012, and several important new advances were reported in the therapy of this disease. Culminating in the approval of a new therapy in the USA, the year offered new insights for clinicians and fresh hope for patients.
In 2012, several new concepts emerged that widen our view of the regulation of bone mass in health and disease. Three key studies outline these discoveries, which affect our understanding of the skeletal system, particularly its physiological function and the changes it undergoes during inflammatory disease.
2012 has witnessed new developments in targeted therapies for osteoarthritis, and in ways to identify those patients who might benefit most from their application. Together, these advances could go some way to addressing the urgent need for disease-modifying treatments for this common disease.
Advances in 2012 have helped to solve several established mysteries in spondyloarthritis (SpA)—why T-cell-directed therapies have not delivered the expected efficacy and how the IL-23–IL-17 cytokine axis is linked to the specific pathology of SpA. The opportunity to influence disease progression at inflammatory lesions using anti-TNF agents may be fleeting.
