Reviews & Analysis

Anti-tumor necrosis factor therapy is used to treat patients with psoriasis; however, use of this therapy for the treatment for other immune-mediated disorders has been associated with the onset of psoriasis or psoriasiform lesions in some patients. In this Viewpoint, Dr Laurindo and Dr Scheinberg discuss the clinical implications of, and potential explanations for, this paradoxical effect of tumor necrosis factor blockade.

This Viewpoint discusses the enrolment of patients into clinical trials as a means to provide access to medications that would not otherwise be available to them. Dr Romain argues that there are inherent problems associated with this mode of treatment.

Detecting and treating rheumatoid arthritis as early as possible in the disease stage can mean that long-term treatment might not be necessary. In this Viewpoint, Dr Liang and colleagues propose a novel method for the identification of persons with symptoms of early rheumatoid arthritis in the general population.

Current guidelines for classification of symptoms of neuropsychiatric systemic lupus erythematosus have not proven helpful for the dissection of pathological mechanisms of this disorder or the identification of appropriate therapy. A reclassification of symptoms is proposed in this Viewpoint; the new scheme is based on pathoanatomic localization of the disease.