Volume 10 Issue 4, April 2014

Understanding the genetics of rheumatoid arthritis (RA) is complex, multiple genes and environmental factors are involved. A new multicentre genetic study summarizes the fundamental gene polymorphisms, pathways and cell types that are related to RA and, based on this analysis, proposes new targets for RA drug treatments.

Patients with systemic sclerosis present with varying clinical features, have different responses to therapy, and end up with different outcomes. Categorizing patients improves disease management. A new study now proposes that patients with systemic sclerosis and overlapping features of another connective tissue disease might form a distinct disease subset.

Rheumatoid arthritis is associated with an excess risk of cardiovascular disease, but current cardiovascular risk models might not be adequate to fully predict individual risk in a patient with this disease. Does the solution lie in closer collaboration between rheumatologists and cardiologists?

Pain is a debilitating symptom of juvenile idiopathic arthritis (JIA) that can persist despite effective disease control. Insights into the underlying mechanisms of pain in JIA could highlight new treatment approaches and improve management. Here, the neurobiological basis of pain in JIA is described, using findings from animal models to inform the situation in humans.

That many autoimmune rheumatic diseases have an extended preclinical period, during which autoimmunity develops and evolves, is becoming apparent. In this Review, the authors discuss the current knowledge of the preclinical pathogenesis of rheumatoid arthritis and systemic lupus erythematosus, and use these diseases as models to highlight how such understanding could, in the future, improve therapeutic intervention and even lead to preventative approaches in autoimmune rheumatic diseases.

Eicosanoids are major regulators of inflammation and are thought to be involved in the pathogenesis of rheumatic diseases. Here, the authors provide an overview of eicosanoid pathways in a variety of rheumatic diseases (including rheumatoid arthritis, osteoarthritis and gout, among others) and describe how targeting this pathway might lead to novel anti-inflammatory treatment strategies.

Hand osteoarthritis (OA) is a common disease and the prevalence is expected to increase further with ageing of the general population. In this comprehensive Review, Margreet Kloppenburg describes the nonpharmacological and pharmacological management strategies currently available to alleviate the symptoms of hand OA.

The concepts of comorbidity and multimorbidity consider a patient with multiple diseases from different perspectives, which affects how a clinician approaches treatment. In this Perspectives article, Radner and colleagues discuss the concept of multimorbidity and how its integration into daily clinical practice can improve the care of patients with rheumatic conditions.