Volume 16 Issue 1, January 2020

The 2019 ACR–SAA–SPARTAN treatment recommendations for axial spondyloarthritis incorporate useful advice on new therapies, treatment strategy and the use of imaging. But is it appropriate to still recommend different treatment strategies for non-radiographic and radiographic disease when available evidence suggests they are part of the same clinical spectrum?

B cells can assume protective or pathogenic roles in immune-mediated diseases (IMDs). Analysis of the B cell receptor (BCR) repertoires in six IMDs provides insights into the diversity of B cell repertoires across diseases as well as into potential pathological mechanisms and the effects of different treatments.

NSAIDs are first line therapy for patients with axial spondyloarthritis and are recommended to be taken continuously in patients with active disease, but their ability to affect radiographic disease progression has been uncertain. Does a new meta-analysis shed light on this matter, or is it too soon to tell?

Myofibroblasts are important mediators of wound healing but can also perpetuate fibrosis in diseases such as systemic sclerosis by evading apoptosis. Therapeutic targeting of the survival mechanisms used by these cells in fibrotic disease holds promise for the reversal of fibrosis.

Repurposing of drugs for and among rheumatic autoimmune inflammatory diseases can introduce promising new treatments. New knowledge about these diseases and the development of data-driven techniques are identifying new pathways and targets for repurposing.

Behavioural economics uses psychological and economical insights to explain decision making by individuals to understand the predictable way in which individuals behave irrationally. Concepts from this field can be applied to promote healthy behaviours and could be applicable to rheumatology.