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In this Review, the authors examine how the definition and description of axial spondyloarthritis (axSpA) has evolved, most notably with the introduction of the concept of non-radiographic axSpA, and discuss the implications of these changes for diagnosis, classification and therapy.
Loss of B cell tolerance to autoantigens in systemic lupus erythematosus (SLE) is driven by TLR7, whereas TLR9 appears to protect against SLE by limiting the stimulatory activity of TLR7. The unique features of Toll-like receptor signalling in B cells implicate it as a therapeutic target in SLE.
The immunogenicity of a biologic agent can have clinical consequences in terms of response to therapy and risk of adverse events. In this Review, the authors summarize the latest data on the immunogenicity of biologic agents for various rheumatic indications.
For the past two decades, remission has been the focus of treatment strategies for rheumatoid arthritis (RA). This Review addresses the differences between remission and cure in RA and the underlying factors (‘drivers’) that trigger chronic inflammation and prevent cure.
Refractory rheumatoid arthritis (RA) can present with or without signs of ongoing inflammation. A better understanding of the mechanisms behind refractory RA in the presence and absence of inflammation could help to improve the treatment of this condition.
Nerve growth factor has been investigated as a therapeutic target for osteoarthritis and chronic low back pain, yet worries over adverse effects have stalled drug development. This Review provides an update on the current status of nerve growth factor inhibitors.
The development of osteoarthritis (OA) correlates with an increase in the number of senescent cells in joint tissues and the senescence-associated secretory phenotype is implicated in cartilage degradation and OA. Eliminating or altering senescent cells with senolytics or senomorphics could stop OA progression and pathogenesis.
Antinuclear antibodies (ANAs) are valuable biomarkers for various autoimmune rheumatic diseases and can be detected using various assays. This Review discusses the advantages and disadvantages of different ANA assays, to help in the understanding and interpretation of ANA test results.
In this Review, the authors describe the pathophysiological targets and clinical effects of new drugs currently being investigated for the treatment of osteoarthritis.
The association of immune-mediated necrotizing myopathy (IMNM) with myositis-specific autoantibodies has led to the classification of three subclasses of IMNM and provided insight into the pathogenesis of, and treatment options for, these inflammatory myopathies.
In this Review, the authors discuss how new approaches, including imaging, tissue analysis and omics technologies, could be applied to identify patients with a poor prognosis and to predict response to treatment, thus enabling precision medicine and improving outcomes in psoriatic disease.
Fibromyalgia is a complex and common condition characterized by chronic widespread pain and numerous other symptoms. This Review outlines different clinical aspects of fibromyalgia, including the burden, diagnosis and treatment of this condition, and discusses various hypotheses of fibromyalgia etiopathogenesis.
The effects of sex steroids (oestrogens, androgens and progesterone) on immune responses contribute to the sex bias in autoimmune rheumatic diseases in complex ways. Targeting these effects could hold potential for treating patients with autoimmune rheumatic diseases.
Over the past few years, considerable advances have been made in understanding the pathogenesis of IgG4-related disease. Our increased knowledge of the important roles of B cells and T cells is now starting to make its way into the clinic.
Antinuclear antibodies (ANAs), characteristic features of systemic lupus erythematosus (SLE), are a requirement for disease classification and trial enrolment. In this Review, the authors re-examine the role of ANAs in SLE and discuss changing attitudes towards using ANAs as biomarkers.
Fibroblast growth factor signalling pathways have crucial roles in the development and maintenance of healthy cartilage. In this Review, the authors discuss strategies for targeting these pathways in osteoarthritis and cartilage repair.
Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are heterogeneous, interrelated diseases. This Review outlines current evidence on the monitoring and long-term management of patients with GCA and PMR, including the tapering of treatment and the handling of complications.
The DNA methylation profile of various cells types are altered in autoimmune rheumatic diseases. Particular DNA methylation profiles are associated with the prognosis, subtype, progression and/or treatment responses of various rheumatic diseases and hence have potential as clinical biomarkers.
Digital health technologies (DHTs) have a variety of interesting current and possible future applications in rheumatology. In this article, the authors describe some of the key barriers that prevent DHT integration into rheumatology care and discuss ways in which these barriers could be addressed.
In this article, the authors summarize the latest clinical and basic research on gut inflammation in spondyloarthritis and highlight important questions to address in future research.
