Reviews & Analysis

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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.

    • Marius Henriksen
    News & Views
  • In this Evidence-Based Guideline article, an international multidisciplinary working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases presents recommendations for the diagnosis, monitoring and treatment of osteoporosis in men.

    • Nicholas R. Fuggle
    • Charlotte Beaudart
    • Nicholas C. Harvey
    Evidence-based Guidelines
  • 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.

    • Chrissy Bolton
    • Adam P. Croft
    News & Views
  • 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.

    • Michael F. McDermott
    News & Views
  • Tyrosine kinase 2 (TYK2), a Janus kinase family member, is involved in immune signalling and is implicated in autoimmune diseases such as systemic lupus erythematosus; inhibitors of TYK2 show promise in treating various diseases and potentially offer advantages over other Janus kinase inhibitors.

    • Eric Morand
    • Joseph F. Merola
    • Roy Fleischmann
    Review Article
  • Beyond the traditional classification of monogenic or complex, many genetic diseases can be considered genetically transitional disease. In this Perspective, the authors consider the application of the genetically transitional disease model to rheumatic diseases and the potential implications for patient care, genetic counselling and research.

    • Timothy B. Niewold
    • Ivona Aksentijevich
    • Qingping Yao
    Perspective
  • Immunoengineering involves the design of materials with specific properties relating to the immune system. In this Review the authors consider the application of immunoengineering to systemic autoimmune diseases via site-specific and antigen-specific immunoregulation, the facilitation of immune cell therapy, novel approaches to immunodiagnostics and the generation of models to study autoimmunity.

    • David A. McBride
    • Ryan M. Jones
    • Nisarg J. Shah
    Review Article
  • 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.

    • Mohamad Bittar
    • Atul Deodhar
    News & Views
  • Deep learning is a powerful technique with great potential for the analysis and interpretation of rheumatological images. To successfully use deep learning, rheumatologists should understand the tasks involved in image processing and the potential confounders and limitations that can affect the analysis of clinical data.

    • Berend C. Stoel
    • Marius Staring
    • Annette H. M. van der Helm-van Mil
    Review Article
  • Juvenile idiopathic arthritis treatment has evolved with new therapies, early remission goals and global efforts, including randomized trials and a treat-to-target strategy. This Review summarizes current evidence and therapeutic approaches to the management of non-systemic phenotypes of juvenile idiopathic arthritis.

    • Susan Shenoi
    • Gerd Horneff
    • Angelo Ravelli
    Review Article
  • This Review discusses the interplay of the gut microbiome and the immune system in the context of systemic lupus erythematosus. Dysbiosis and gut-barrier dysfunction are implicated in promoting disease and are potential therapeutic targets.

    • Gregg J. Silverman
    • Doua F. Azzouz
    • Abhimanyu Amarnani
    Review Article
  • 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.

    • Scott A. Rodeo
    News & Views
  • 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.

    • Ranjeny Thomas
    • William H. Robinson
    News & Views
  • This Review explores the potential of emerging RNA-based technologies and cell-engineering strategies, including those that incorporate small interfering RNA, microRNA, mRNA and synthetic receptor-mediated gene editing, to provide innovative and targeted approaches to osteoarthritis therapy.

    • Carlisle R. DeJulius
    • Bonnie L. Walton
    • Craig L. Duvall
    Review Article
  • 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.

    • Ariane L. Herrick
    • Gisela Orozco
    News & Views
  • In this Review, the authors describe shared pathophysiology of systemic juvenile idiopathic arthritis and adult-onset Still’s disease and their life-threatening complication, macrophage activation syndrome. Therapeutic developments now enable the targeting of multiple pathways in these conditions, and evidence suggests that early use of DMARDs has the potential to prevent chronic disease.

    • Piero Ruscitti
    • Luca Cantarini
    • Roberto Giacomelli
    Review Article
  • Studies published in 2023 emphasize the long-term efficacy and safety of novel therapeutics for both radiographic and non-radiographic axial spondyloarthritis (axSpA) and provide a consensus definition of ‘early axSpA’ for use in research studies.

    • Diego Benavent
    • Victoria Navarro-Compán
    Year in Review
  • Advances in gene, protein and cellular engineering provide unprecedented opportunities to redirect immune cells to treat autoimmunity. In 2023, novel cellular and precision immunotherapies showed remarkable promise in the treatment of rheumatic diseases.

    • Maximilian F. Konig
    Year in Review