Volume 16 Issue 7, July 2020

Methotrexate is commonly used in combination with biologic DMARDs in the treatment of rheumatoid arthritis on the basis that the combined therapy has synergistic benefits. New data challenge this concept in the treatment of older adults and highlight the uncertainty of the mode of action of methotrexate in this population.

Baseline immune variation predicts immune responses during vaccination, and the gene signatures capturing such immune variation seem to correlate with systemic lupus erythematosus (SLE) disease activity. Will the definition of these gene sets enable the development of the much needed concept of personalized medicine in SLE?

The heterogeneity of systemic lupus erythematosus (SLE) confounds the diagnosis and treatment of this disease, and attempts at disease stratification are nascent. Researchers have identified a common set of biomarkers in patients with SLE that could identify new therapeutic targets and lead to new clinical assays to help address this issue.

Results from phase II randomized controlled trials (RCTs) determine whether promising therapeutics will progress to phase III. According to detailed analyses in rheumatoid arthritis and psoriatic arthritis, phase II efficacy data systematically overestimate subsequent phase III results, raising the question of how this discrepancy might be addressed in future RCTs.

Atherosclerotic cardiovascular disease is a major cause of morbidity and mortality in patients with rheumatoid arthritis. In this Review, Semb and colleagues outline atherosclerotic cardiovascular disease risk management and prevention for patients with rheumatoid arthritis.

Gout is a chronic crystal deposition disorder in which sustained hyperuricaemia leads to formation and deposition of monosodium urate crystals in the joints. The prevalence and incidence of gout are increasing globally, which may be related to changes in the prevalence of gout risk factors (such as obesity) and comorbidities.

This Review outlines the pathophysiology of Kawasaki disease and discusses the progress gained from experimental mouse models and their potential therapeutic translation to human disease.