Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
Immune checkpoint inhibitors, which are used to treat many types of cancer, can cause syndromes similar to rheumatic diseases known as immune-related adverse events (irAEs). In 2020, several studies illustrated the clinical heterogeneity of rheumatic irAEs and highlighted their substantial effect on morbidity and mortality.
Since the outset of the COVID-19 pandemic, numerous risk factors for severe disease have been identified. Whether patients with rheumatic diseases, especially those receiving DMARDs, are at an increased risk of SARS-CoV-2 infection or severe COVID-19 disease remains unclear, although epidemiological studies are providing some insight.
In inflammatory arthritides, such as rheumatoid arthritis (RA), synovial cells acquire aggressive and disruptive phenotypes that lead to joint disease. Three studies published in 2020 have described phenotypic variation in synovial cells, offering a novel perspective on the potential to resolve pathology and augment treatment options for patients with RA.
Multisystem inflammatory syndrome in children (MIS-C) is a rare complication of SARS-CoV-2 infection that can result in serious illness in the paediatric population but our understanding of this syndrome is in its infancy. Translational studies in 2020 leveraging immune profiling have laid the foundation to enable further discovery in MIS-C.
Interest in therapies for psoriatic arthritis (PsA) has increased in response to recognition that many patients remain undiagnosed and are inadequately treated. In 2020, advances in PsA treatments have included phase III trials of an IL-23 inhibitor, head-to-head trials of IL-17 inhibition against TNF inhibition and updated EULAR treatment guidelines.
Interstitial lung disease (ILD) can arise in a variety of connective tissue diseases (CTDs) and various treatment interventions are being explored. In 2020, advances in the treatment of CTD-associated ILD have included the re-evaluation of methotrexate-induced lung injury and emerging insights on anti-IL-6 therapy and anti-fibrotic therapy in this condition.
The immunogenicity of a biologic agent can have clinical consequences in terms of response to therapy and risk of adverse events. In this Review, the authors summarize the latest data on the immunogenicity of biologic agents for various rheumatic indications.
Loss of B cell tolerance to autoantigens in systemic lupus erythematosus (SLE) is driven by TLR7, whereas TLR9 appears to protect against SLE by limiting the stimulatory activity of TLR7. The unique features of Toll-like receptor signalling in B cells implicate it as a therapeutic target in SLE.
In this Review, the authors examine how the definition and description of axial spondyloarthritis (axSpA) has evolved, most notably with the introduction of the concept of non-radiographic axSpA, and discuss the implications of these changes for diagnosis, classification and therapy.
In this article, the authors critically appraise the current model of opinion-based academia–industry interactions, and advocate for a realignment towards partnerships that foster innovation and knowledge.
