Therapeutic advancements in juvenile idiopathic arthritis
Publication date: April 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 2 Author(s): Elizabeth A. Kessler , Mara L. Becker The treatment of juvenile idiopathic arthritis (JIA) has substantially evolved over the past two decades. Research has been conducted and is ongoing on how therapies can best be utilized either as monotherapy or in combination for enhanced efficacy. The introduction of biologic therapies that selectively target specific cytokines has changed the acceptable clinical course of childhood arthritis. In addition to the development and utilization of new therapeutic age...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Macrophage activation syndrome and cytokine-directed therapies
Publication date: April 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 2 Author(s): Grant S. Schulert , Alexei A. Grom Macrophage activation syndrome (MAS) is an episode of overwhelming inflammation that occurs most commonly in children with systemic juvenile idiopathic arthritis (SJIA). It is characterized by expansion and activation of T lymphocytes and hemophagocytic macrophages and bears great similarity to hemophagocytic lymphohistiocytosis (HLH). This disorder has substantial morbidity and mortality, and there is frequently a delay in recognition and initiation of treatment. He...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

A practical approach to the diagnosis of autoinflammatory diseases in childhood
Publication date: April 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 2 Author(s): Silvia Federici , Marco Gattorno Autoinflammatory diseases are characterized by the presence of chronic or recurrent systemic inflammation secondary to abnormal activation of innate immunity pathways. Many of these diseases have been found to have mutations in the genes within these pathways. Due to their rarity, non-specific symptoms and the very recent genetic and phenotypic identification and recognition, a delay in diagnosis is common. Nevertheless, some specific clinical features should help the ...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Methodology of clinical trials for rare diseases
Publication date: April 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 2 Author(s): Catrin Tudur Smith , Paula R. Williamson , Michael W. Beresford Evidence from clinical trials, ideally using randomisation and allocation concealment, is essential for informing clinical decisions regarding the benefits and harms of treatments for patients. Where diseases are rare, such as in paediatric rheumatic diseases, patient recruitment into clinical trials can be a major obstacle, leading to an absence of evidence and patients receiving treatments based on anecdotal evidence. There are numerous...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Update on research and clinical translation on specific clinical areas: From bench to bedside: How insight in immune pathogenesis can lead to precision medicine of severe juvenile idiopathic arthritis
Publication date: April 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 2 Author(s): Sebastiaan Vastert , Berent Prakken Despite the enormous progress in the treatment of juvenile idiopathic arthritis (JIA), innovations based on true bench-to-bedside research, performed in JIA patients, are still scarce. This chapter describes novel developments in which clinical innovations go hand in hand with basic discoveries. For the purpose of this review, we will mainly focus on developments in severe forms of JIA, most notably systemic JIA and polyarticular JIA. However, also in less severe fo...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Overview of neurodevelopment and pain research, possible treatment targets
Publication date: April 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 2 Author(s): Suellen M. Walker Pain is a common presenting and often persistent symptom for children with rheumatological disease. Pain is not clearly related to disease severity in children with inflammatory juvenile idiopathic arthritis, and presentations of non-inflammatory musculoskeletal pain are common but there is limited evidence to guide management. Pain assessment must extend beyond measures of pain severity to more fully evaluate characteristics of pain, functional impact and psychosocial effects and fa...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Granulomatous inflammation: The overlap of immune deficiency and inflammation
We describe with some detail extrapulmonary sarcoidosis, Blau syndrome, and immunodeficiency associated granulomatous inflammation, which in our view are the paradigmatic primary forms of granulomatous diseases in childhood. The other entities are presented only as differential diagnoses listing their most relevant clinical features. This chapter shows that almost all granulomatous diseases seen in adults can be found in children and that there are some entities that are essentially pediatric at onset, namely Blau syndrome and most forms of immunodeficiency associated granulomatous diseases. (Source: Best Practice and Rese...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Genetics, genomics, and their relevance to pathology and therapy
Publication date: April 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 2 Author(s): Michael J. Ombrello , Keith A. Sikora , Daniel L. Kastner Genetic and genomic investigations are a starting point for the study of human disease, seeking to discover causative variants relevant to disease pathophysiology. Over the past 5 years, massively parallel, high-throughput, next-generation sequencing techniques have revolutionized genetics and genomics, identifying the causes of many Mendelian diseases. The application of whole-genome sequencing and whole-exome sequencing to large populations h...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

‘Erratum to “Osteoporosis and fragility fractures: Vertebral fractures” [Best Practice & Research Clinical Rheumatology 27 (2013) 743–55]’
Publication date: June 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 3 Author(s): Paul Gerdhem (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Corrigendum to “Granulomatous inflammation: the overlap of immune deficiency and inflammation” [Best Pract Res Clin Rheumatol 28 (2014) 191–212]
Publication date: June 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 3 Author(s): Carlos D. Rose , Benedicte Neven , Carine H. Wouters (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

A public health approach to musculoskeletal health
Publication date: June 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 3 Author(s): P.M. Clark , B.M. Ellis An ageing, physically inactive and increasingly obese population, coupled with finite health and social care resources, requires a shift from treating musculoskeletal disease when it arises to a preventive approach promoting lifelong musculoskeletal health. A public health approach to musculoskeletal health ensures that people are able to live not only long, but also well. Supporting self-management, addressing common misconceptions about the inevitability of musculoskeletal con...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Moving from evidence to practice: Models of care for the prevention and management of musculoskeletal conditions
Publication date: June 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 3 Author(s): Robyn Speerin , Helen Slater , Linda Li , Karina Moore , Madelynn Chan , Karsten Dreinhöfer , Peter R. Ebeling , Simon Willcock , Andrew M. Briggs With musculoskeletal conditions now identified as the second highest cause of the morbidity-related global burden of disease, models of care for the prevention and management of disability related to musculoskeletal conditions are an imperative. Musculoskeletal models of care aim to describe how to operationalise evidence-based guidelines for musculoske...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Lifestyle modifications to improve musculoskeletal and bone health and reduce disability – A life-course approach
Publication date: June 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 3 Author(s): Graeme Jones , Tania M. Winzenberg , Michele L. Callisaya , Laura L. Laslett This review covers the evidence relating to lifestye modification in the big three musculoskeletal conditions: osteoarthritis, osteoporosis and rheumatoid arthritis. Lifestyle is of considerable importance in the first two and there is emerging evidence for rheumatoid arthritis despite it not traditionally being considered a lifestyle disease. (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Determinants of MSK health and disability: Lifestyle determinants of symptomatic osteoarthritis
Publication date: June 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 3 Author(s): Marlene Fransen , Milena Simic , Alison R. Harmer It is frequently considered that, for many people, symptomatic osteoarthritis involving the lower limb joints is a largely preventable ‘lifestyle disease’. The purpose of this review is to evaluate the most recent scientific evidence examining the effect of various lifestyle factors, such as physical activity, obesity, diet, smoking, alcohol and injury, on the development of symptomatic knee or hip osteoarthritis. The strengths and weaknesse...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Determinants of MSK health and disability – Social determinants of inequities in MSK health
Publication date: June 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 3 Author(s): Francis Guillemin , Erin Carruthers , Linda C. Li Even in most egalitarian societies, disparities in care exist to the disadvantage of some people with chronic musculoskeletal (MSK) disorders and related disability. These situations translate into inequality in health and health outcomes. The goal of this chapter is to review concepts and determinants associated with health inequity, and the effect of interventions to minimize their impact. Health inequities are avoidable, unnecessary, unfair and unjus...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Musculoskeletal health, frailty and functional decline
Publication date: June 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 3 Author(s): R. Milte , M. Crotty Frailty in older people is associated with a vulnerability to adverse events. While ageing is associated with a loss of physiological reserves, identifying those with the syndrome of frailty has the potential to assist clinicians to tailor treatments to those at the risk of future decline into disability with an increased risk of complications, morbidity and mortality. Sarcopenia is a key component of the frailty syndrome and on its own puts older people at risk of fragility fractu...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

A time for action: Opportunities for preventing the growing burden and disability from musculoskeletal conditions in low- and middle-income countries
Publication date: June 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 3 Author(s): Damian Hoy , Jo-Anne Geere , Fereydoun Davatchi , Belinda Meggitt , Lope H. Barrero Musculoskeletal (MSK) conditions cause an enormous global burden, and this is dramatically increasing in developing countries, particularly due to rapidly ageing populations and increasing obesity. Many of the global non-communicable disease (NCD) initiatives need to expand beyond the traditional ‘top four’ NCD groups by incorporating MSK diseases. It is critical that MSK initiatives in developing countries ...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Defining the principles of musculoskeletal disability and rehabilitation
Publication date: June 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 3 Author(s): Reuben Escorpizo Disability is strongly associated with musculoskeletal conditions such as arthritis, low back pain and other soft tissue and joint disorders. The burden of these conditions may become exponentially high in the absence of rehabilitation. To understand disability, the ICF (International Classification of Functioning, Disability and Health) provides the framework to disentangle the different domains that comprise disability. Disability in ICF term is defined as an impairment of the body f...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Burden of disability due to musculoskeletal (MSK) disorders
Publication date: June 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 3 Author(s): Lyn March , Emma U.R. Smith , Damian G. Hoy , Marita J. Cross , Lidia Sanchez-Riera , Fiona Blyth , Rachelle Buchbinder , Theo Vos , Anthony D. Woolf This chapter summarises the global and regional prevalence, disability (Years Lived with Disability (YLDs)) and overall burden (Disability Adjusted Life Years (DALYs)) and costs for the common musculoskeletal disorders including low back and neck pain, hip and knee osteoarthritis, rheumatoid arthritis, gout, and a remaining combined group of other MSK con...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Seronegative rheumatoid arthritis: Pathogenetic and therapeutic aspects
Publication date: August 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 4 Author(s): Arthur G. Pratt , John D. Isaacs Rheumatoid arthritis (RA) has long been recognised as a highly heterogeneous disease of immune dysregulation. Despite an ever-growing appreciation of the role of circulating autoantibodies in the development of ‘seropositive’ disease, the pathogenesis of seronegative RA remains poorly understood. Accumulating evidence suggests that RA ‘serotypes’, in fact, reflect distinct disease entities that, despite their clinical overlap, diverge in respec...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Inhibitors of angiogenesis: Ready for prime time?
Publication date: August 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 4 Author(s): Chrissta X. Maracle , Sander W. Tas Angiogenesis plays a crucial role in the pathogenesis of inflammatory diseases, including rheumatoid arthritis (RA). Therefore, targeting neovascularization in RA may hold great therapeutic potential. Several mediating factors are involved in synovial angiogenesis, including growth factors, cytokines, chemokines, adhesion molecules, and matrix-remodeling enzymes. This review aims to summarize the current understanding of these contributing factors in RA, as well as...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Vagus nerve stimulation: A new bioelectronics approach to treat rheumatoid arthritis?
Publication date: August 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 4 Author(s): F.A. Koopman , P.R. Schuurman , M.J. Vervoordeldonk , P.P. Tak There has been a marked improvement in the treatment of rheumatoid arthritis (RA), but most patients do not achieve disease remission. Therefore, there is still a need for new treatments. By screening an adenoviral short hairpin RNA library, we discovered that knockdown of the nicotinic acetylcholine receptor type 7 (α7nAChR) in RA fibroblast-like synoviocytes results in an increased production of mediators of inflammation and degra...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Small-molecule therapeutics in rheumatoid arthritis: Scientific rationale, efficacy and safety
Publication date: August 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 4 Author(s): Florian M.P. Meier , Iain B. McInnes Rheumatoid arthritis (RA) remains a formidable clinical challenge. This is despite remarkable recent advances in our understanding of pathogenesis and the introduction of a variety of novel agents, particularly biologic therapeutics that are potent inhibitors of extracellular immune pathways. Whereas the latter have brought substantial improvements in efficacy and thus outcomes, there remain significant numbers of non- or partial responders to current standard of ...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Mesenchymal stromal cells for treatment of arthritis
Publication date: August 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 4 Author(s): J.F. Swart , N.M. Wulffraat Patients with refractory inflammatory arthritis can still respond favourable to autologous haematopoietic stem cell transplantation. However, this treatment has a high morbidity and even 5% mortality. Mesenchymal stromal cells (MSC), a subset of the non-haematopoietic stromal cells obtained from bone marrow, were found to have a strong immunosuppressive effect. MSC treatment is explored in many diseases like diabetes, SLE, MS and RA. This review covers all relevant literat...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Epigenetic changes: The missing link
Publication date: August 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 4 Author(s): Diego Kyburz , Emmanuel Karouzakis , Caroline Ospelt The association of rheumatoid arthritis (RA) with a number of genetic risk loci is well established; however, only part of the risk to develop the disease is based on genetics. Environmental factors significantly contribute to the pathogenesis. A gene–environment interaction for smoking and certain major histocompatibility complex (MHC) class II alleles has been shown to promote anti-citrullinated protein antibody (ACPA)-positive RA; however,...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Stroma: Fertile soil for inflammation
Publication date: August 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 4 Author(s): Rikesh Patel , Andrew Filer , Francesca Barone , Christopher D. Buckley Biological therapies for the management of immune mediated inflammatory diseases such as rheumatoid arthritis have proven to be extremely successful in recent years. Despite these successes, even the most effective of therapies do not lead to cure. Why chronic inflammation persists indefinitely within the rheumatoid synovium despite an absence of continuous stimulation, and why some patients with early synovitis progress to persi...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

How undifferentiated arthritis evolves into chronic arthritis
Publication date: August 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 4 Author(s): D. van der Woude , R.E.M. Toes , H.U. Scherer Undifferentiated arthritis (UA) is a frequently occurring clinical presentation with a variable outcome. While some forms of UA will spontaneously remit, other forms will progress to chronic arthritis; an outcome that would preferably be prevented. Which immunological factors are normally at the basis of resolution of inflammation, and what, on the other hand, causes inflammation to persist? This review provides an overview of the immunological mechanisms...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Molecular and cellular heterogeneity in the Rheumatoid Arthritis synovium: Clinical correlates of synovitis
Publication date: August 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 4 Author(s): Michael J. Townsend Rheumatoid Arthritis is characterized by autoimmune-mediated attack of the joint synovial lining resulting in destruction of bone and cartilage, and is a clinically and biologically heterogenous disease with respect to both course of disease and outcome to therapy. The current armamentarium of approved therapies does not result in complete clinical response in all patients. Improved techniques for imaging and performing biopsies on the rheumatoid synovium have facilitated multiple...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Concepts of pathogenesis and emerging treatments for inflammatory arthritis
Publication date: August 2014 Source:Best Practice & Research Clinical Rheumatology, Volume 28, Issue 4 Author(s): Jacob M. van Laar , Arthur Kavanaugh (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Adverse effects of TNF inhibitors in SpA: Are they different from RA?
Publication date: Available online 31 October 2014 Source:Best Practice & Research Clinical Rheumatology Author(s): Percival D. Sampaio-Barros , Irene E. van der Horst-Bruinsma Tumor necrosis factor (TNF) inhibitors were the first biologic drugs prescribed for the treatment of spondyloarthritis (SpA) and rheumatoid arthritis (RA). Although they provide significant improvement of signs and symptoms, TNF inhibitors need to be used frequently for a long period of time. The analysis of the follow-up of the largest national biologics registries has shown that the most important adverse effect of TNF inhibitors is infe...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Nonpharmacologic therapies in spondyloarthritis
Publication date: Available online 1 November 2014 Source:Best Practice & Research Clinical Rheumatology Author(s): Andreas M. Reimold , Vinod Chandran It is accepted that the optimal management of spondyloarthritis requires a combination of non-pharmacological and pharmacological interventions. Non-pharmacologic therapy in spondyloarthritis has generally focused on the exercise regimens whose purpose is to maintain mobility and strength, relieve symptoms, prevent or decrease spinal deformity, contribute to long-term cardiopulmonary health, and improve overall function and quality of life. Exercise programs such ...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Bone formation in axial spondyloarthritis
Publication date: Available online 1 November 2014 Source:Best Practice & Research Clinical Rheumatology Author(s): Rik J. Lories , Nigil Haroon The success of targeted therapies directed against tumor necrosis factor for patients with spondyloarthritis has shifted the focus of physicians and scientists towards the prevention of structural damage to the involved structures, in particular the sacroiliac joints and the spine, to avoid loss of function and disability. Structural damage to the skeleton as witnessed by radiography mainly consists of new bone formation potentially progressively leading to spine or join...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Novel imaging modalities in spondyloarthritis
This article will cover the role of, and the sensitivity and specificity of magnetic resonance imaging (MRI) and ultrasound in the diagnosis and monitoring of axial and peripheral SpA. It will discuss how the definition of a ‘positive MRI’ of the sacroiliac joints and spine is evolving. Differential diagnoses of inflammatory lesions of both the sacroiliac joints and the spine are addressed due to their importance in image interpretation. The article will also discuss the role of sonography in assessing peripheral entheses, joints, tendon sheaths, nails and soft tissues. The utility for clinical as well as an ou...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Disease activity measurements and monitoring in psoriatic arthritis and axial spondyloarthritis
Publication date: Available online 7 November 2014 Source:Best Practice & Research Clinical Rheumatology Author(s): Pedro M. Machado , Siba P. Raychaudhuri In addition to the critical need of measuring tools for drug development of spondyloarthritis (SpA), these tools are also valuable for patient management. An early diagnosis, determination of early therapeutic response, and monitoring therapeutic response have now become increasingly important because effective therapies are available, and therapies such as anti-tumor necrosis factor (TNF) drugs are even more effective if used in early disease stages. In this ...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Spontaneous, drug-induced, and drug-free remission in peripheral and axial spondyloarthritis
Publication date: Available online 10 November 2014 Source:Best Practice & Research Clinical Rheumatology Author(s): Denis Poddubnyy , Lianne S. Gensler In spondyloarthritis (SpA), spontaneous remission is best described in reactive arthritis, a form of peripheral SpA. Prior SpA observational studies suggested that a significant percentage of patients reached spontaneous remission; however, these patients were followed up under older, broader European Spondyloarthropathy Study Group (ESSG) criteria or were not defined by specific criteria. In general, they were mixed populations of peripheral and axial disease, a...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

The role of the gut and microbes in the pathogenesis of spondyloarthritis
Publication date: Available online 15 November 2014 Source:Best Practice & Research Clinical Rheumatology Author(s): Mark Asquith , Dirk Elewaut , Phoebe Lin , James T. Rosenbaum The intestinal microbiota is firmly implicated not only in the pathogenesis of inflammatory bowel disease (IBD) but increasingly also in the development of inflammation at extraintestinal tissue sites. Significant clinical, genetic, immunological, and microbiological overlap exists between IBD and spondyloarthritis (SpA), which indicates that pathophysiological mechanisms are shared between these diseases and may center on the intestinal...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

The concept of spondyloarthritis: Where are we now?
This article provides a historical evolution of the concept of SpA, from the Rome Criteria to the ASAS criteria, current issues and barriers with the use of ASAS criteria, and the work that still needs to be done moving forward. (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Treatment of spondyloarthritis beyond TNF-alpha blockade
Publication date: Available online 18 November 2014 Source:Best Practice & Research Clinical Rheumatology Author(s): Filip Van den Bosch , Atul Deodhar The advent of biologics targeting tumor necrosis factor-alpha (TNF-alpha) has revolutionized the field of rheumatology in general and the treatment of spondyloarthritis (SpA) in particular, since – apart from non-steroidal anti-inflammatory agents – no disease modifying treatments are available for this frequent, inflammatory rheumatic condition. The significant improvements in signs and symptoms observed with TNF-blockers in this group of diseases, ha...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Pharmacologic treatment of psoriatic arthritis and axial spondyloarthritis with traditional biologic and non-biologic DMARDs
Publication date: Available online 22 November 2014 Source:Best Practice & Research Clinical Rheumatology Author(s): Enrique Roberto Soriano , Maria Laura Acosta-Felquer , Phat Luong , Liron Caplan This manuscript focuses on the pharmacologic treatment of psoriatic arthritis and axial spondyloarthritis – including ankylosing spondylitis – using traditional biologic and non-biologic disease-modifying antirheumatic drugs. Early treatment of psoriatic arthritis and axial spondyloarthritis/ankylosing spondylitis as well as the treat-to-target concept receive particular attention. This review also surveys ...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Genetics of psoriatic arthritis
Publication date: Available online 22 November 2014 Source:Best Practice & Research Clinical Rheumatology Author(s): Darren D. O'Rielly , Proton Rahman Spondyloarthritis (SpA) represents a group of inflammatory rheumatic diseases that cluster within families and possess overlapping clinical features. The pathogenesis of SpA encompasses a complex array of genetic, immunological and environmental factors. In this article, we will briefly review the genetics of PsA, and then focus on the genes that may be potentially linked either directly or indirectly to the immunopathology of the Th-17 pathway. The most consisten...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

The role of mechanical stress in the pathogenesis of spondyloarthritis and how to combat it
Publication date: Available online 22 November 2014 Source:Best Practice & Research Clinical Rheumatology Author(s): Peggy Jacques , Dennis McGonagle Given that entheses are sites of high mechanical stress that concentrate the forces of large contracting muscles down onto a small footprint of bone contact, it was recognized nearly 60 decades ago that stress and injury at such sites may play a role in the pathogenesis of mechanically related enthesopathy. In recent years, the role of mechanical stress and its related consequences on inflammatory enthesitis have also been recognized. Clinical imaging studies and ex...
Source: Best Practice and Research Clinical Rheumatology - December 4, 2014 Category: Rheumatology Source Type: research

Current concepts in the pathogenesis of early rheumatoid arthritis
Publication date: February 2009 Source:Best Practice & Research Clinical Rheumatology, Volume 23, Issue 1 Author(s): Arthur G. Pratt , John D. Isaacs , Derek L. Mattey Rheumatoid arthritis (RA) is a systemic inflammatory disease with a predilection for symmetrically distributed diarthroidal joints. It is clinically heterogeneous, with particular disease phenotypes defined according to a complex interplay of genes and the environment. In this chapter we first summarize current knowledge of RA genetic susceptibility, a field which has been transformed in recent years by powerful modern genotyping technologies. The ...
Source: Best Practice and Research Clinical Rheumatology - October 12, 2014 Category: Rheumatology Source Type: research

Addressing patient beliefs and expectations in the consultation
Publication date: April 2010 Source:Best Practice & Research Clinical Rheumatology, Volume 24, Issue 2 Author(s): Chris J. Main , Rachelle Buchbinder , Mark Porcheret , Nadine Foster In this article, we specifically focus on the identification and management of patient beliefs and expectations during consultations with health-care professionals (HCPs). In examination of the nature and purpose of communication during consultations, we evaluate the research relating to doctor–patient communication, present the Calgary–Cambridge framework and highlight the identification and management of the patient's b...
Source: Best Practice and Research Clinical Rheumatology - October 12, 2014 Category: Rheumatology Source Type: research

Why and how back pain interventions work: What can we do to find out?
Publication date: October 2013 Source:Best Practice & Research Clinical Rheumatology, Volume 27, Issue 5 Author(s): Gemma Mansell , Steven J. Kamper , Peter Kent Mediation analysis is a useful research method that potentially allows identification of the mechanisms through which treatments affect patient outcomes. This chapter reviews the theoretical framework, research designs and statistical approaches used in mediation analysis. It describes what can be learnt from previous mediation research, much of which has investigated mediating factors of psychosocial interventions in other health conditions. It also sum...
Source: Best Practice and Research Clinical Rheumatology - October 12, 2014 Category: Rheumatology Source Type: research