Volume 11 Issue 1, January 2015

In systemic sclerosis (SSc), new classification criteria highly sensitive to early and limited forms of the disease could facilitate not only the recognition of early SSc, but also the discovery of biomarkers of poor prognosis, with potential benefits for conducting clinical trials.

The positive results of the phase II programme of fostamatinib, developed to target the spleen tyrosine kinase pathway in rheumatoid arthritis (RA), have not been replicated in phase III. What implications might the results have for the development of other oral inhibitors of intracellular kinases in the treatment of RA?

Epigenetic regulation is a vital driver of the aetiology of human disease, with research breakthroughs now occurring on a regular basis. Several studies investigating CpG methylation of cartilage DNA from patients with osteoarthritis are generating exciting insight into this common but complex disease.

The presence or absence of autoantibodies in patients with rheumatoid arthritis (RA) can guide clinical practice, but the role of autoantibody status in 'real life' is unclear. A cohort study from Canada provides clinical perspective on the presentation, prognosis and efficacy of treatment of patients with autoantibody-negative RA.

In this Review, Martinon and Aksentijevich highlight the latest developments in research into the pathogenesis of autoinflammatory diseases. Newly discovered disease-causing mutations and molecular pathways underlying inherited autoinflammatory diseases are discussed.

Although osteoarthritis can be slowed by biologic therapy, surgical interventions are necessary to recover cartilage function. In this Review of cartilage repair techniques, the authors outline how currently accepted methods can fall short in providing a long-term solution of hyaline cartilage regeneration and discuss preclinical and clinical trials of new cell scaffold-based, cell-free scaffold-based and scaffold-free procedures.

In osteoarthritis (OA), chronic, low-grade inflammatory processes promote the symptoms and progression of the disease. In this Review, the authors discuss the inflammatory pathophysiology in OA, including networks of inflammatory mediators in OA joints, transcriptional reprogramming of chondrocytes, and abnormal bioenergetics and proteostasis mechanisms, and consider the potential to target these processes for the treatment of OA.

In this Review, skeletal ontogeny is compared to fracture healing mechanisms. The authors describe developments in our understanding of the different stages of fracture healing as well as the latest therapies tested in animal models and in clinical trials, focusing on bone morphogenetic proteins or parathyroid hormone based treatments.

Rheumatic diseases are a common health-care problem in Thailand. Patient care is influenced not only by differences in the prevalence, clinical traits and genetic variants of these diseases in Thailand compared with other countries, but by the country's health-care systems, availability of medicine and physicians, and rheumatology training, education and research. The author provides his expert view of the current challenges and barriers, recent successes and future prospects of rheumatology in Thailand.