Volume 10 Issue 2, February 2014

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.

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.

Several advances in 2013 have improved our understanding of how epigenetic mechanisms affect autoimmune disorders. Many new insights were made into the regulation of gene expression by DNA methylation in systemic lupus erythematosus. For rheumatoid arthritis, complex interrelationships between DNA methylation and microRNAs in regulating gene expression were described.

With every passing year, research on the pathogenesis of rheumatoid arthritis benefits from discoveries in other scientific fields. Three of the best examples that illustrate the benefit of such interdisciplinary bridges and the effects they have on our understanding of rheumatoid arthritis are presented here.

Although advances in therapy of rheumatoid arthritis (RA) have greatly improved disease outcomes, a considerable portion of patients still do not attain clinical remission. Thus, new treatments targeting a range of cytokines and cell types are being explored. This Review outlines these novel approaches to RA therapy.

Juvenile-onset fibromyalgia (JFM) is a complex chronic pain syndrome that can have debilitating effects, but is poorly understood. Here, the authors provide a timely update on the current research in JFM, outlining the latest understanding in the clinical characteristics, prognosis, pathophysiology and management of this condition.

This Review presents a comprehensive guide to nonpharmacological management strategies and current therapies for systemic lupus erythematosus (SLE). The authors offer insights to help the clinician select appropriate, individualized treatments, according to disease severity, symptoms and organ involvement.

Rheumatoid arthritis is associated with a number of extra-articular complications, including inflammatory ophthalmological manifestations. In this Review, the authors describe the key features of episcleritis, scleritis and peripheral ulcerative keratitis in the context of rheumatoid arthritis, as well as provide insights into the management of each condition.

Mesenchymal stem cells (MSCs) have shown some degree of therapeutic benefit and MSC-based therapies are currently offered at many centres worldwide; nevertheless, firm scientific evidence of the effectiveness and safety of such therapies is severely lacking, and a number of issues regarding the characterization and manipulation of MSCs remain to be adequately clarified. Alan Tyndall discusses these issues and provides his opinion on the optimism shown to such therapies to date.