Review Articles

In this Review, the authors discuss the challenges of multimorbidity, polypharmacy and geriatric syndromes in older patients with inflammatory rheumatic diseases. They note that individually tailored interventions are needed in this patient group in order to preserve patient independence and overall functioning.

The quality of life of patients with diffuse cutaneous systemic sclerosis is greatly affected by progressive painful and itchy skin tightening. Here, Herrick, Assassi and Denton describe skin involvement, the prediction of progression, outcome measures, imaging techniques and best-practice management.

Axial spondyloarthritis, an immune-mediated inflammatory disease, is characterized by chronic back pain, joint stiffness and fatigue that can severely affect the quality of life. This Review summarizes the progress in the pharmacological management of this disease, including newly approved biologic DMARDs.

Targeted therapies, including biologic DMARDs and Janus kinase inhibitors, can interfere with the mechanisms of pathological bone metabolism in inflammatory arthritis. In this Review, the authors discuss the effects of these therapies on local and generalized bone changes.

In this Review, the authors summarize the current knowledge relating to SARS-CoV-2 infection and the prevention and treatment of COVID-19 in people with rheumatic disease.

This Review examines the biology of synovial inflammation, the cell types involved, their interactions and the role of synovitis in the development and progression of osteoarthritis.

Erosive hand osteoarthritis is an aggressive condition with poor outcomes. In this Review, the authors describe the clinical features and risk factors associated with erosive hand osteoarthritis, and summarize progress in the areas of biomarkers, imaging, classification criteria and treatment.

Here, the authors describe the mechanisms that normally limit function and survival of activated T cells in peripheral tissues and discuss how defects in these processes can facilitate the development of chronic inflammatory responses that underlie organ damage in rheumatic autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis.

In this Review, Paggi et al. discuss the requirements and challenges in engineering a joint-on-chip device, propose an architecture for such a model of the joint and highlight the potential for these platforms to further advance insight into arthritic diseases and facilitate drug development.

This Review discusses progress in identifying potential outcome measures and developing treatment options to achieve a treat-to-target approach in systemic lupus erythematosus, as well as the research advances that are needed to realize these objectives.

Several rheumatic diseases are associated with an increased risk of cardiovascular disease. In this Review, the authors outline the role of neutrophils in rheumatic disease pathogenesis and in vascular inflammation, and draw parallels with cardiovascular disease.

Janus kinase inhibition modulates a range of immune and inflammatory processes. In this Review, the authors discuss progress in the therapeutic use of Janus kinase inhibitors in autoimmune rheumatic diseases, with a focus on their disease-specific mechanisms of action.

The pathways involved in sensing and responding to mechanical stimuli have important roles in maintaining cartilage health, and can contribute to disease when dysregulated. This Review discusses cartilage mechanosignalling pathways and how they can be targeted to treat osteoarthritis.

In this Review, Choi et al. review the pathogenesis of cardiometabolic-renal comorbidities of gout and discuss potential therapies to concurrently reduce serum urate concentrations and risk of gout cardiometabolic-renal comorbidities.

In this Review, the authors summarize the clinical features, management and prognosis of acute exacerbation of interstitial lung disease in patients with rheumatic diseases, and discuss the definitions and diagnostic criteria for this often life-threatening condition.

Vasculitis, inflammation of the blood vessels, takes many forms and can affect every organ system, potentially causing kidney failure, vision loss and death. This Review describes current knowledge on the global incidence and prevalence patterns for various types of vasculitis.

In this Review, the authors introduce the application of artificial intelligence, in particular machine learning and deep learning, for improving multiple stages of MRI, including acquisition, processing and post-processing steps, for studying osteoarthritis.

In this Review, the authors discuss the immunometabolic alterations involved in the pathogenesis of intervertebral disc degeneration, including the role of adipokines in impaired metabolism in intervertebral disc cells, and discuss opportunities for future research and development of new therapies.

Differentiating between the early stages of systemic lupus erythematosus (SLE) and undifferentiated connective tissue disease (UCTD) can be challenging. In this Review, the authors summarize current knowledge on UCTD and early-stage SLE and discuss clinical approaches to diagnosing these conditions.

In this Review, the authors provide an introduction to machine learning and discuss the use of this approach in rheumatic autoimmune inflammatory diseases, including the classification of patients based on medical records or molecular characteristics, identification of novel biomarkers or drug repurposing candidates and prediction of disease progression or onset.