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Interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) is associated with considerable morbidity and mortality. In this Review, various unmet needs in the management of SSc–ILD are discussed, and solutions are proposed to help improve outcomes for these patients.
Treatment of ‘classic’ systemic juvenile idiopathic arthritis (sJIA) is evolving markedly, and treatment options for early sJIA without arthritis, and refractory or complicated sJIA are not well defined. This Review outlines current approaches and provides an outlook on knowledge gaps.
Treatment of patients with arthralgia during the ‘window of opportunity’ could prevent disease development or a severe disease course. This Review summarizes available information on the completed and ongoing prevention trials in rheumatoid arthritis, including patient preferences and future considerations.
In this Review, the authors present epidemiological data relating to the idiopathic inflammatory myopathies and summarize the current understanding of the risk factors associated with these conditions, as well as highlighting areas that require further research.
The autoimmune disease systemic sclerosis is characterized by fibrosis, which is poorly targeted by the use of anti-inflammatory and immunosuppressive drugs. In this Review, the authors describe the fibrotic mechanisms underlying SSc and attempts to develop drugs to specifically target the fibrotic extracellular matrix.
Placebo responses are prevalent in clinical trials for osteoarthritis, and they hinder the identification of effective new treatments. In this Review, Colloca and Neogi describe various aspects of the placebo phenomenon, and demonstrate how this knowledge can help to improve the design of clinical trials.
In this Review, the authors provide an overview of the therapeutic effects of uricases, outcomes related to gout and its comorbidities in clinical trials and challenges surrounding the use of uricases as potent urate-lowering therapy for the treatment of gout.
New evidence demonstrates that myelopoiesis in the bone marrow is a critical event in inflammatory arthritis and is maintained by acquired memory in innate immune cells, which perpetuate inflammation and tissue destruction.
Extracellular vesicles derived from mesenchymal stromal cells provide the therapeutic benefits of the parental cells with advantages relating to immunogenicity and ease of handling. This Review discusses the therapeutic potential of native and modified extracellular vesicles for the treatment of rheumatic diseases, focusing on osteoarthritis and rheumatoid arthritis.
The TNF–TNF receptor signalling network has pleiotropic effects that can both promote and protect against immune-mediated diseases. Modulation of this network through the use of TNF receptor-targeting biologic drugs holds promise for treating various diseases, including TNF inhibitor-refractory diseases.
In this Review the authors outline the evidence for how sleep disturbance and inflammation interact in a positive feedback spiral in rheumatoid arthritis, leading to further inflammation, pain and progression of disease activity.
Vaccines are important tools for protection against infectious diseases, particularly in patients undergoing immunosuppression (including DMARD therapy). This Review discusses the effects of DMARDs on vaccine immunogenicity, focusing on influenza and SARS-CoV-2 vaccines, and potential mechanisms underlying these effects.
The potential for the co-occurrence of spondyloarthritis and inflammatory bowel disease means that gastroenterologists must identify articular manifestations and rheumatologists must identify intestinal manifestations. This Review describes the progress in the treatment of patients with both spondyloarthritis and inflammatory bowel disease.
This Review provides an overview of the complement system and its role in a range of rheumatic and autoimmune diseases, and examines the rapidly expanding landscape of complement therapeutics in these settings, as well as prospects for improving their clinical use.
Post-transcriptional regulation of gene expression is important in various cellular processes, and disruption of this process can lead to aberrant immune responses, including autoimmune processes. This Review discusses the role of post-transcriptional checkpoints in autoimmunity and potential therapeutic implications.
Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are increasingly viewed as parts of a single disease spectrum. In this Review, the authors outline how stratification of patients with GCA–PMR spectrum disease using clinical, imaging and laboratory data can to help guide therapy.
Cartilage defects often fail to heal, which can lead to degenerative changes and ultimately to osteoarthritis. This Review discusses various hypotheses for why articular cartilage fails to regenerate and accompanying potential therapeutic solutions.
Rheumatoid arthritis is associated with an excess risk of atherosclerotic cardiovascular disease. This Review summarizes shared inflammatory pathways between rheumatoid arthritis and atherosclerotic cardiovascular disease that are targeted by existing therapies, and lessons learnt from clinical trials of these drugs.
Bone marrow lesions (BMLs) are considered possible biomarkers and therapeutic targets in osteoarthritis, but human studies of BMLs have important limitations. In this Review, the authors explore the utility and potential of animal models in BML research.
This Review provides an overview of the clinical features and subtypes, pathophysiology and management of juvenile idiopathic inflammatory myopathies, including updates to our understanding of this heterogenous group of diseases that might change clinical practice in the near future.
