Review Articles in 2018

Nakazawa and colleagues describe advances in our understanding of anti-neutrophil cytoplasmic antibody-associated vasculitis. These insights have already generated promising new treatments that target B cells, T cells and cytokines; potential novel approaches targeting additional cells or molecules are also discussed.

The treatment of systemic lupus erythematosus involves a balance between control of disease activity and prevention of therapeutic harm that requires careful optimization. In this Review, the authors discuss available and emerging therapeutic strategies that exploit the current drug armamentarium.

Gene therapy and tissue engineering strategies for the treatment of cartilage repair each pose unique challenges to clinical translation. Could combining the two approaches open new avenues for the treatment of articular cartilage defects in patients with osteoarthritis?

Intra-articular therapies for knee osteoarthritis (OA) are causing excitement among clinicians and patients, but care should be taken when choosing which therapy to use. In this Review, Vangsness and colleagues critically appraise current and future intra-articular therapies for knee OA.

Stromal cells of mesenchymal origin can help to sustain inflammation in the joint by various mechanisms; understanding these mechanisms could inform new therapeutic strategies and explain why joint inflammation persists in diseases of the joint such as arthritis, enthesopathy and tendinopathy.

Hydroxychloroquine is a front-line treatment for systemic lupus erythematosus and other rheumatic diseases, but can cause retinopathy. Improved detection techniques for the early stages (pre-symptomatic) of retinopathy has led to recommendations for reduced dosing, but more data on the efficacy of low-dose hydroxychloroquine are needed.

Nocebo effects can occur in patients with rheumatic and/or musculoskeletal diseases, and might result in suboptimal treatment outcomes or non-adherence. The consideration of nocebos is important in rheumatology practice and clinical trial design, including when switching patients to biosimilars.

The ability to resolve, rather than suppress, inflammation could enable new possibilities for the treatment of chronic diseases such as rheumatoid arthritis. Knowing more about the function of immune-regulatory cytokines is the first step towards realizing their therapeutic potential.

Our ability to interrogate the genetic and epigenetic processes that underpin disease are advancing rapidly. In this Review, Radstake and colleagues highlight insights gained into the pathogenesis of systemic sclerosis from the past 4 years of genetic and epigenetic research.

Hand osteoarthritis (OA) is a heterogeneous and prevalent condition involving multiple joints. In this Review, the authors provide an update on the epidemiology, presentation and burden of hand OA, as well as on advances in imaging techniques, disease management and pathogenesis.

Both spondyloarthritis and uveitis are associated with HLA-B27 positivity. This Review discusses this overlap and how the intestinal microbiome and dysbiosis might contribute to the development of both diseases.

The IL-23–IL-17 signalling pathway has paradoxical effects on bone remodelling in psoriatic arthritis and ankylosing spondylitis. In this Review, Gravallese and Schett examine the evidence for and outline the reasons behind this paradox.

Adult-onset Still’s disease (AoSD) is not easily diagnosed, and treatment options are limited. This Review provides an overview of the disease and its pathogenesis, clinical trial results, therapeutic options and a plan to diagnose and clinically manage these patients.

The deposition of calcium-containing crystals can result in various acute and chronic arthropathies. Understanding the biological effects of these crystals and underlying pathogenic mechanisms might inform on the development of future therapeutic strategies for these conditions.

Cancer immunotherapies that function as checkpoint inhibitors are an exciting development but are associated with immune-related adverse events that can occur in almost any organ. Among these events are complications that mirror established rheumatic diseases, so oncologists and rheumatologists must work together.

The two major lung complications in systemic sclerosis, lung fibrosis and pulmonary arterial hypertension, share some pathogenic mechanisms. Strategies for managing patients with these complications have greatly advanced in the past decade, and many tools and treatments are now available.

Preclinical rheumatoid arthritis (RA) is characterized by the presence of RA-related autoantibodies in the serum in the absence of clinical symptoms. This Review discusses the relationships during this period between mucosal alterations and the initiation of local and systemic anti-citrullinated protein antibody production.

B cell depletion has become standard-of-care for the treatment of ANCA-associated vasculitis, but can more be done to target B cells? In this Review, the authors look beyond rituximab to alternative B cell-targeting therapies and novel therapeutic combinations.

S100 proteins have many intracellular functions, as well as being extracellular signalling molecules in inflammation. A deeper understanding of this family of proteins could lead the way to diagnostic and prognostic biomarkers and novel therapeutic strategies.

Evidence from genetic, experimental and clinical studies has accumulated to indicate a role for the IL-17 pathway in the pathogenesis of spondyloarthritis. This Review discusses how IL-17A and IL-17F and their cellular sources contribute to the immunopathology of these diseases.