Volume 11 Issue 8, August 2015

An inverse relationship between BMI and risk of death has been noted in patients with rheumatoid arthritis. Does being overweight or obese really have a favourable effect on mortality in these individuals, or could other factors explain the association?

The quest for new biomarkers of response to therapies in rheumatoid arthritis (RA), particularly to TNF inhibitors, continues. Two recent studies add to this body of literature, finding both established and novel genetic variants that correlate with response to TNF inhibitors in RA.

Arthroscopic surgery to remove torn meniscal tissue is a controversial treatment that, together with the meniscal tear itself, is associated with a high risk of developing knee osteoarthritis (OA). But what of surgical approaches to repair or replace the meniscus? Are these procedures justified with respect to the later development of OA?

Intriguing parallels can be drawn between the immune mechanisms leading to rheumatoid arthritis and coeliac disease, which point to a crucial role for T cell–B cell cooperation in both diseases. This article highlights recent developments in understanding the contributions of specific HLA molecules and antibodies against post-translationally modified protein antigens to these diseases.

This article discusses the many heritable and nonheritable factors contributing to primary osteoporosis, focusing on osteogenesis imperfecta, juvenile osteoporosis and other monogenic disorders associated with increased bone fragility. Understanding these conditions not only illuminates the pathogenesis of osteoporosis, but could also lead to the discovery of new therapeutic targets.

Considerable progress has been made in understanding the pathologic processes and pathophysiology of Kawasaki disease. This article also discusses genetic susceptibility to Kawasaki disease and describes current approaches to treatment of the acute stage of the disease.

The distinction between autoimmunity and autoinflammation has become an important issue in rheumatic diseases. The mechanisms by which the immune system is tolerant to self-antigens—and how this tolerance can be lost in some situations—is a central point in this distinction. In this Review, van Kempen et al. explores the different pathways at work in autoimmune and autoinflammatory diseases, and how this knowledge might help improve treatment strategies.

Treatment optimization studies have paved the way for success of new therapies in paediatric oncology. The majority of children with cancer are treated within treatment optimization study protocols (TOSPs), but this is not the case for children with common rheumatic diseases such as juvenile idiopathic arthritis. In this Opinion article, Niehues suggests the recruitment of children with rheumatic diseases into TOSPs, making use of rheumatology research networks already established, would secure standardized treatments and outcome measures and could improve patient care considerably.