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Given a lack of head-to-head comparisons of the efficacy and safety of different biologic agents for the treatment of rheumatoid arthritis, can we instead compare systematic reviews that assess one agent at a time, or does heterogeneity between studies limit the usefulness of this approach?
Polymyalgia rheumatica is widely acknowledged as the most common form of inflammatory rheumatic disease in the elderly. Two recent studies by Hernandez-Rodriguez et al. and Dasgupta et al. attempt to synthesize and pragmatize recommendations for the evaluation and treatment of this disorder.
A new set of clinical practice guidelines on the nonpharmacological treatment of rheumatoid arthritis is likely to improve patient accessibility to appropriate and coordinated therapy. The recommendations are classified according to therapeutic objectives and indications, and include a set of quality criteria for self-assessment and practice improvement.
This Review discusses the role of endothelial dysfunction as a marker of the accelerated atherosclerosis associated with rheumatoid arthritis. The authors outline how the assessment of endothelial function could be useful in relation to the early identification and monitoring of cardiovascular risk in patients with the disease.
Tendons are designed to withstand considerable loads but repetitive use often results in injuries, such as tendinopathy. Concurrent with overt symptoms, a number of histological and molecular changes occur within the collagen fibril constituents of tendon. Progress in understanding how collagen, and various other components of the human tendon, respond to acute and chronic loading is outlined in this Review.
Systemic sclerosis is complex disease for which effective therapies remain elusive. In this Review article, Ramos-Casals and colleagues highlight therapeutic approaches to the treatment of systemic sclerosis, and suggest that the future of systemic sclerosis therapy might be as multifaceted as the disease itself.
The accumulation of postapoptotic cell remnants resulting from inefficient phagocytic clearance might lead to the initiation and maintenance of systemic autoimmune reactions and chronic inflammation—hallmarks of systemic lupus erythematosus (SLE). The consequences of apoptotic cell accumulation for the etiology, pathogenesis and pathophysiology of SLE are summarized in this Review.
This article describes the genetic heterogeneity in rheumatoid arthritis between Asian and European populations, and how these differences might underlie the pathogenesis of the disease.
Antiphospholipid syndrome (APS) is characterized by recurring arterial or venous thromboses, which places patients at high risk of a variety of life-threatening conditions. This short, focused Review summarizes the prevalence and risk factors associated with death in patients with APS or its more severe variant, catastrophic APS.
If a patient with rheumatoid arthritis does not respond to treatment with a tumor necrosis factor (TNF) inhibitor, which biologic agent should be administered next: a second anti-TNF agent or an agent with a different mechanism of action? This article explores the issues and evidence surrounding the physician's dilemma.
