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The past decade has seen exciting progress in the management of lupus nephritis, a manifestation of systemic lupus erythematosus that accounts for its major morbidity and mortality. The American College of Rheumatology has issued new guidelines for screening and treatment of lupus nephritis, based on expert recommendations.
Determining the potential success of investigational therapies for rheumatoid arthritis early in the development process would enable better allocation of increasingly limited resources. Such 'go or no-go' decision-making could be improved by a method of analysing longitudinal clinical trial data to establish a threshold for success of a new drug.
Study of the efficacy of fracture prevention approaches has been neglected in men, in comparison with women. Guidelines from the Endocrine Society for the management of osteoporosis and fracture risk in men are thus welcome, but further research into fracture prevention in men is required.
In the absence of definitive diagnostic tests, several schemes for the classification of paediatric vasculitis have been devised and periodically updated, but are these revisions necessary and useful?
Risk factors-genetic and environmental-for rheumatoid arthritis (RA) are gradually becoming clear, leading to considerable heterogeneity in the pathological processes and clinical features of this disease. Preclinical abnormalities can precede manifestation of symptoms by a decade. Precisely how endogenous predisposing factors interact with environmental triggers to produce clinical disease remains unclear, but the authors of this Review unite diverse strands of research to present a state-of-the-art mechanism for RA pathogenesis.
Osteoporosis and vascular calcification share a number of pathogenetic mechanisms. In this article, the authors discuss the pathophysiology of the interaction between these two processes, and review clinical evidence that confirms the correlation between osteoporosis and cardiovascular disease.
Peripheral neuropathy is a common neurological disorder that can be observed in the context of a range of rheumatic diseases. In this Review, Vallat and colleagues provide a broad overview of the different types of peripheral neuropathy that can be associated with rheumatic disease, with a particular emphasis on recognition and diagnosis of the condition.
In this update on the genetics of hyperuricaemia and gout, the authors describe the associations between common genetic variants, serum uric acid levels and gout as well as the role of these genetic variants in gout pathogenesis. Pharmacogenetic associations betweenHLA-B*5801and severe allopurinol-hypersensitivity reactions and the potential causal role of urate in cardiovascular disease are also discussed.
Research in osteoarthritis (OA) is among the most collaborative in rheumatology, and the Osteoarthritis Initiative is championing efforts to pool expertise and data in imaging studies in OA. The rationale for, undertaking of, and emerging results from this project are outlined in this Perspectives article, with an emphasis on how they will advance the understanding and treatment of OA.
