Volume 6 Issue 11, November 2010

A meta-epidemiological study has revealed that the inclusion of small studies in meta-analyses of osteoarthritis interventions could lead to an overestimation of the benefit of these interventions. Does this mean meta-analyses should be restricted to trials with large sample sizes?

Immunosuppression has been associated with viral reactivation in patients with chronic viral infections. A prospective study has concluded that it is safe to use anti-tumor-necrosis-factor agents in patients with chronic hepatitis B virus infection receiving antiviral prophylaxis. Is there sufficient evidence to back up this conclusion?

Therapeutic strategies are in development that aim to use T_REG cells in autoimmune diseases. The feasibility of such an approach is challenged, however, by recent findings suggesting that the chronic phase of autoimmune inflammation might not be controlled by these cells. What impact could this study have on the development of T_REG cell-based therapies for human diseases?

Bacterial infection is known to trigger a number of autoimmune disorders, an observation that indicates a potentially important role for antibiotics in treating these diseases. Indeed, results from an experimental model of autoimmune arthritis in mice suggest that antibiotics can prevent the onset of disease.

Clinical trials demonstrate that intensive treatment of early rheumatoid arthritis with a combination of DMARDs improves short-term outcomes. An extension study from a pivotal trial has now shown that such intensive early therapy can achieve a reduction in the rate of erosive progression over a period of 11 years.

Moving beyond the view of osteoarthritis as a disease of the cartilage, evidence is emerging that synovial inflammation is an important factor in the pathophysiology of the disease. In this article, Sellam and Berenbaum review that evidence, present various methods of assessing synovitis, and discuss the possibility of synovitis-targeted therapy for the treatment of osteoarthritis.

Knowledge of the role of regulatory B (B_REG) cells in immune suppression and autoimmunity has improved. In this Review, the authors describe the advances in the study of B_REG cells, detailing the known B_REG cell subsets and the ontogeny and development of these cells. The authors also highlight the role of B_REGcells in human health and disease and their potential use as a therapy for a wide range of rheumatic diseases.

Many factors can influence the safety and effectiveness of biologic therapies for rheumatoid arthritis (RA) and, as outlined in this Review, the unique genetic, environmental and medical backgrounds of Japanese individuals could affect how they respond to biologic agents. This article describes the biologic agents used in Japan and the extensive post-marketing surveillance data for all patients with RA treated with biologic agents in Japan, which include the drug-related adverse events that have been documented.

ANCA-associated vasculitides (AAV) involve inflammation and fibrinoid necrosis of the vessel wall. This Review highlights advances in our understanding of the cells and molecules that contribute to AAV pathogenesis and discusses new developments in the treatment of these diseases.

In the first of two Perspectives articles regarding the use of MRI to detect inflammatory lesions in early preclinical axial spondyloarthritis, De Rycke and colleagues question the diagnostic value of this technique, citing inconsistencies and selection bias in a number of validation studies.

In the second of two Perspectives articles regarding the use of MRI to detect inflammatory lesions in early preclinical axial spondyloarthritis, van der Heijde et al. defend the inclusion of MRI sacroiliitis in the 2009 ASAS classification criteria and acknowledge the importance of expert opinion in the diagnosis of this disease.