Reviews & Analysis

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  • Given that intra-articular injections for the knee of treatments such as hyaluronic acid, stem cells and platelet-rich plasma are advised against or only weakly recommended by current clinical-practice guidelines, why do people continue to seek information about these treatments?

    • Vicky Duong
    • David J. Hunter
    News & Views
  • Emerging research suggests that chimeric antigen receptor T cell therapy could be an effective treatment for a range of difficult-to-treat autoimmune diseases, and sophisticated approaches are in tests, yet initial reports also highlight several questions that remain to be answered.

    • Terri H. Finkel
    • Marko Radic
    News & Views
  • Among the wide range of drugs now available for the treatment of psoriatic arthritis, the best option for an individual patient remains unclear. Emerging real-world evidence from several Nordic registries suggests that differences exist in the response rates to different classes of biologic and targeted synthetic DMARDs in psoriatic arthritis.

    • Helena Marzo-Ortega
    • Stephanie R. Harrison
    News & Views
  • The full picture of post-COVID-19 autoimmune diseases and their prevalence is lacking despite numerous case reports and small series. Two studies that use large cohorts now highlight that SARS-CoV-2 infection is linked to a substantially increased risk of developing a diverse spectrum of new-onset autoimmune diseases.

    • Chetan Sharma
    • Jagadeesh Bayry
    News & Views
  • Clinical heterogeneity in systemic lupus erythematosus (SLE) is a challenge to effective treatment. This Review describes advances in our understanding of genetic and epigenetic variations in SLE and the roles of immune profiling and biomarker identification in the progress towards precision medicine.

    • Serena Fasano
    • Alessandra Milone
    • Francesco Ciccia
    Review Article
  • The onset of the destructive autoimmune joint disease rheumatoid arthritis (RA) is preceded by the development of autoantibodies to multiple citrullinated proteins. Research has now shown that citrullination modifies antigen processing, resulting in the production of cryptic epitopes, suggesting a new model for RA autoantibody development.

    • Jean Roudier
    • Isabelle Auger
    News & Views
  • Among the limited quality and quantity of evidence on vaccination use in individuals with rheumatic and musculoskeletal diseases, a new guideline, developed with a rigorous methodology, provides useful support to clinicians and patients in making health-related decisions. Most recommendations are conditional, serving as a call to action for further research.

    • Inés Colmegna
    • Michael Libman
    News & Views
  • Osteoarthritis has many appearances and can stabilize or progress aggressively. However, there is not yet an aetiological classification of osteoarthritis subtypes. Can in silico approaches, despite difficulties in validation, help with the identification of experimentally challenging subtypes? And if they can, will these approaches translate to clinical benefits?

    • Corrinus C. van Donkelaar
    News & Views
  • The involvement of citrulline-specific CD4+ T cells in anti-citrulline protein antibody-positive rheumatoid arthritis (RA) is well described, whereas less attention has been given to CD8+ T cells. New data suggest that CD8+ T cells also contribute to citrulline-specific immune responses in RA.

    • Karine Chemin
    • Vivianne Malmström
    News & Views
  • This Review summarizes the genetic and epigenetic basis of primary Sjögren syndrome, including genetic interactions with factors such as sex and environment. Understanding these processes provides insight into the molecular basis of this disease and might reveal new treatment targets.

    • Gudny Ella Thorlacius
    • Albin Björk
    • Marie Wahren-Herlenius
    Review Article
  • In systemic lupus erythematosus, renal involvement is known as lupus nephritis and it is associated with mortality and morbidity. This Review compares and contrasts the existing management guidelines for lupus nephritis and describes emerging therapeutic approaches and the feasibility of precision medicine.

    • Chi Chiu Mok
    • Y. K. Onno Teng
    • Yoshiya Tanaka
    Review Article
  • Pope et al. review the current management (including both screening and treatment) of organ-based manifestations of systemic sclerosis as well as overall disease modification, with a focus on evidence from clinical trials and consensus recommendations.

    • Janet E. Pope
    • Christopher P. Denton
    • Tatiana Nevskaya
    Review Article
  • An ambitious project to update the classification of vasculitis syndromes has culminated in the development of new classification criteria for anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, Takayasu arteritis and giant cell arteritis. Endorsed by the ACR and EULAR, the new criteria reflect progress in the understanding and assessment of these conditions.

    • Giacomo Emmi
    • Augusto Vaglio
    News & Views
  • Sarcopenia, which involves the generalized loss of skeletal muscle strength and mass, is commonly associated with rheumatoid arthritis. In this Review, the authors discuss the epidemiology, pathophysiology and identification of rheumatoid sarcopenia and present evidence for the therapeutic roles of physical activity, nutrition and pharmacotherapy.

    • Joshua L. Bennett
    • Arthur G. Pratt
    • John D. Isaacs
    Review Article
  • Next-generation sequencing has led to the discovery of multiple rare autoinflammatory diseases, together with their corresponding disease-causing mutations, creating opportunities to develop personalized medicine and providing useful insight into more common forms of autoimmunity and autoinflammation.

    • Jonathan J. Miner
    • Katherine A. Fitzgerald
  • In this Review, the authors describe the relationships between persistent DNA damage, inflammation and cellular senescence, which represent a common pathway that contributes to the pathology of many conditions, including rheumatic diseases.

    • Antonio Pezone
    • Fabiola Olivieri
    • Armando Gabrielli
    Review Article
  • The mechanisms underlying the genetic association between HLA-B27 and ankylosing spondylitis, including the contribution of endoplasmic reticulum aminopeptidase 1 (ERAP1), continue to elude the field. New findings support the involvement of the unfolded protein response and highlight the therapeutic potential and limitations of targeting ERAP1 in this disease.

    • Nigil Haroon
    • Robert D. Inman
    News & Views