Volume 16 Issue 10, October 2020

Pain in osteoarthritis is multifactorial, but a disconnect between radiographic features and symptoms hampers our understanding of pain. New imaging data suggest that pain arises from virtually all structures in the joint and that cartilage loss is only a minor contributor to pain symptoms but is important for disease progression.

Exactly how nucleic acids trigger type I interferon responses via certain Toll-like receptors has been uncertain. Now, a new pathway involving gene products previously linked to systemic lupus erythematosus but not known to interact has been unravelled, which could be of relevance to the female sex bias in this disease.

Early diagnosis of immune-mediated arthropathies is important for early and effective treatment, but often relies on clinical expertise. Can the use of a new genetic risk score help rule out and prioritize certain diagnoses? And does this score add any clinical utility to current clinical diagnostic pathways?

Fibroblast growth factor signalling pathways have crucial roles in the development and maintenance of healthy cartilage. In this Review, the authors discuss strategies for targeting these pathways in osteoarthritis and cartilage repair.

Antinuclear antibodies (ANAs), characteristic features of systemic lupus erythematosus (SLE), are a requirement for disease classification and trial enrolment. In this Review, the authors re-examine the role of ANAs in SLE and discuss changing attitudes towards using ANAs as biomarkers.

A subset of patients with coronavirus disease 19 (COVID-19) develop a thrombotic disorder that resembles a virally induced, complement-mediated thrombotic microangiopathy. Here, the authors present the theory and evidence for this disease model and discuss important considerations for treatment.

In this article, the authors discuss how the use of innovative clinical trial designs could facilitate the efficient evaluation of new and existing drugs in specific subgroups of patients, in order to optimize therapy allocation and address unmet clinical needs.