Reviews & Analysis

In this Review, the authors provide an overview of what is known of the clinical features, pathogenesis and treatment of anti-melanoma differentiation-associated protein 5 antibody-positive dermatomyositis, including emerging biomarkers and clinical subtypes.

In this Review, Pandey and Bhutani describe the use of single-cell ‘omics’ technologies to identify cell subpopulations in joint tissues in health and disease, thereby contributing to the construction of joint cell atlases and the identification of pathogenetic cell subpopulations that are potential therapeutic targets for diseases such as osteoarthritis and rheumatoid arthritis.

Newly published European guidelines for the management of systemic lupus erythematosus (SLE) and lupus nephritis, specifically recommending early and aggressive use of new medications, signal that the old paradigm of SLE management is shifting. Although it presents challenges, this shift is welcome — and is likely to have far-reaching implications.

In this Evidence-Based Guideline article, an international, multidisciplinary group of experts presents evidence-based consensus recommendations on screening for cancer in patients with adult-onset idiopathic inflammatory myopathy, addressing cancer risk stratification, screening modalities and screening frequency.

Depression is a common comorbidity in rheumatoid arthritis, and shared immune mechanisms link the two conditions. This Review explores potential peripheral and central interactions between the immune system and brain, the understanding of which could aid in the development of novel therapeutics.

Interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) is associated with considerable morbidity and mortality. In this Review, various unmet needs in the management of SSc–ILD are discussed, and solutions are proposed to help improve outcomes for these patients.

Treatment of ‘classic’ systemic juvenile idiopathic arthritis (sJIA) is evolving markedly, and treatment options for early sJIA without arthritis, and refractory or complicated sJIA are not well defined. This Review outlines current approaches and provides an outlook on knowledge gaps.

In this Perspective, the authors propose that despite the known similarities between ankylosing spondylitis and axial psoriatic arthritis, the localization of inflammation to bone in ankylosing spondylitis and to ligamentous soft tissue in axial axial psoriatic arthritis differentiates these diseases and has important implications for diagnosis, pathology and treatment.

2023 marks 25 years since the approval of the first biologic drug in rheumatology. In this Viewpoint, five rheumatology researchers discuss how biologic therapy has transformed clinical practice, reflecting on their own experience, past and current challenges and what the future might hold for biologic drugs.

Treatment of patients with arthralgia during the ‘window of opportunity’ could prevent disease development or a severe disease course. This Review summarizes available information on the completed and ongoing prevention trials in rheumatoid arthritis, including patient preferences and future considerations.

This Evidence-Based Guideline presents the first Pan American League of Associations for Rheumatology recommendations for the management of axial spondyloarthritis, addressing therapeutic targets, the use of pharmacological and non-pharmacological interventions and monitoring of patients.

In this Review, the authors present epidemiological data relating to the idiopathic inflammatory myopathies and summarize the current understanding of the risk factors associated with these conditions, as well as highlighting areas that require further research.

A single-cell atlas of the human musculoskeletal system could help to improve the understanding of musculoskeletal function in growth, homeostasis, ageing and disease. This Roadmap delineates the steps required and challenges involved in creating such an atlas.

The autoimmune disease systemic sclerosis is characterized by fibrosis, which is poorly targeted by the use of anti-inflammatory and immunosuppressive drugs. In this Review, the authors describe the fibrotic mechanisms underlying SSc and attempts to develop drugs to specifically target the fibrotic extracellular matrix.

Emerging data suggest that the frequency of long-term opioid use is high among individuals with rheumatic and musculoskeletal diseases, which is of concern given the risks of opioid misuse. But is long-term opioid use really that high or is the situation more complicated?

Placebo responses are prevalent in clinical trials for osteoarthritis, and they hinder the identification of effective new treatments. In this Review, Colloca and Neogi describe various aspects of the placebo phenomenon, and demonstrate how this knowledge can help to improve the design of clinical trials.

In this Review, the authors provide an overview of the therapeutic effects of uricases, outcomes related to gout and its comorbidities in clinical trials and challenges surrounding the use of uricases as potent urate-lowering therapy for the treatment of gout.

In this Perspective, the authors discuss select examples of advancements in high-resolution imaging, functional molecular imaging and artificial intelligence-based analysis that hold promise for addressing current imaging limitations, enabling earlier diagnosis, improved monitoring and ultimately, personalized patient management.

New evidence demonstrates that myelopoiesis in the bone marrow is a critical event in inflammatory arthritis and is maintained by acquired memory in innate immune cells, which perpetuate inflammation and tissue destruction.

Similarities in the pathogenesis and treatment of immune-mediated inflammatory diseases suggest that they can be investigated together in basket trials, to reduce the risk of failure of early-phase drug development and to facilitate the study of rare diseases.