Volume 14 Issue 8, August 2018

Poor medication adherence and depression interfere with the management of patients with systemic lupus erythematosus, especially adolescent and young adult patients. For patients for whom clinic visits and education programs fail to improve adherence, novel social media-based interventions are demonstrating the ability to increase patient agency, self-efficacy, and adherence.

A variety of biologic DMARDs now exist for the treatment of rheumatoid arthritis, but we don’t really know how these drugs function in vivo. Can time-lapse intravital imaging distinguish the modes of action of DMARDs by comparing response to joint destruction in mouse models of arthritis?

A new epidemiological study suggests that only half of patients with hyperuricaemia will go on to develop gout. If ‘the glass is only half-full’, then is hyperuricaemia the most important risk factor for the development of gout?

Some patients with psoriatic arthritis are refractive to one biologic therapy but not to others, and a strategy for selecting the right therapy for each patient is needed. The findings of a new study highlight the potential benefit of stratifying patients by their immunophenotype to select the optimal biologic to use.

As the diagnosis and management of systemic lupus erythematosus (SLE) can be challenging, reclassification of SLE on the basis of biomarker data provides novel insights. Definitions of antinuclear antibodies and attention to SMAARTT criteria (specificity – sensitivity, measurable, actionable, added value, realistic, titres, timely) are needed to translate these new analytical frameworks into real-time clinical use.

Evidence from genetic, experimental and clinical studies has accumulated to indicate a role for the IL-17 pathway in the pathogenesis of spondyloarthritis. This Review discusses how IL-17A and IL-17F and their cellular sources contribute to the immunopathology of these diseases.

A growing body of evidence indicates that neutrophils and neutrophil extracellular traps (NETs) are involved in the progression of rheumatic diseases. This Review focuses on the role of NETs in systemic lupus erythematosus, vasculitis, rheumatoid arthritis and gout.

Leukocytes travel through many different tissues during their lifetime, being educated by the cells and environments they encounter. An increased understanding of this journey in the context of rheumatoid arthritis offers hope for the development of future therapies.

Therapeutic application of cannabis remains controversial despite evidence of pain-relieving functions, particularly for rheumatic diseases. However, whether cannabis can also be used as an immunomodulatory therapeutic agent needs to be counterbalanced by risk assessment for adverse effects.