Biomaterial-assisted cell therapy in osteoarthritis: From mesenchymal stem cells to cell encapsulation
Publication date: Available online 2 June 2018Source: Best Practice & Research Clinical RheumatologyAuthor(s): Fahd Hached, Claire Vinatier, Catherine Le Visage, Henri Gondé, Jérôme Guicheux, Gaël Grimandi, Aurélie Billon-ChabaudAbstractOsteoarthritis (OA) is a degenerative and inflammatory joint disease that affects the cartilage, subchondral bone, and joint tissues. Although current drug therapies can provide a degree of symptomatic relief from pain, they fail to prevent joint damage. Mesenchymal stem/stromal cells (MSCs) have generated significant interest in terms of medical applicat...
Source: Best Practice and Research Clinical Rheumatology - July 6, 2018 Category: Rheumatology Source Type: research

Gaps in appropriate use of treatment strategies in osteoarthritis
Publication date: Available online 19 June 2018Source: Best Practice & Research Clinical RheumatologyAuthor(s): Kelli D. Allen, Yvonne M. Golightly, Daniel K. WhiteAbstractOptimal management of osteoarthritis (OA) requires a combination of therapies, with behavioral (e.g., exercise and weight management) and rehabilitative components at the core, accompanied by pharmacological treatments and, in later stages, consideration of joint replacement surgery. Although multiple sets of OA treatment guidelines have been developed, there are gaps in the implementation of these recommendations. Key areas of concern include the un...
Source: Best Practice and Research Clinical Rheumatology - July 6, 2018 Category: Rheumatology Source Type: research

Gaps in appropriate use of treatment strategies in osteoarthritis
Publication date: Available online 19 June 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Kelli D. Allen, Yvonne M. Golightly, Daniel K. White Optimal management of osteoarthritis (OA) requires a combination of therapies, with behavioral (e.g., exercise and weight management) and rehabilitative components at the core, accompanied by pharmacological treatments and, in later stages, consideration of joint replacement surgery. Although multiple sets of OA treatment guidelines have been developed, there are gaps in the implementation of these recommendations. Key areas of concern include the und...
Source: Best Practice and Research Clinical Rheumatology - June 19, 2018 Category: Rheumatology Source Type: research

Preface: Recent advances in autoimmune and auto-inflammatory diseases in childhood
Publication date: August 2017 Source:Best Practice & Research Clinical Rheumatology, Volume 31, Issue 4 Author(s): A.V. Ramanan, M.W. Beresford (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - June 12, 2018 Category: Rheumatology Source Type: research

Osteoarthritis pain: What are we learning from animal models?
Publication date: Available online 26 April 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Rachel E. Miller, Anne-Marie Malfait All experimental models of osteoarthritis (OA)-like joint damage are accompanied by behaviors indicative of pain. In experimental knee OA, evoked pain responses to exogenously applied stimuli suggest that animals become sensitized to mechanical stimuli. Neurobiological techniques including electrophysiology and in vivo calcium imaging confirm that joint damage is associated with mechanical stimuli through peripheral sensitization. Several mediators present in t...
Source: Best Practice and Research Clinical Rheumatology - June 12, 2018 Category: Rheumatology Source Type: research

New imaging modalities to predict and evaluate osteoarthritis progression
Publication date: Available online 22 May 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Nima Hafezi-Nejad, Ali Guermazi, Shadpour Demehri, Frank W. Roemer In this narrative review, we discuss the role of different imaging methods for the evaluation of progression of structural osteoarthritis. We will focus on the role of less commonly applied imaging modalities and imaging biomarkers that were introduced in recent years or on established methods that have evolved into more prominent positions in recent years. We will highlight findings from longitudinal studies that focused on structural os...
Source: Best Practice and Research Clinical Rheumatology - June 12, 2018 Category: Rheumatology Source Type: research

Biomaterial-assisted cell therapy in osteoarthritis: From mesenchymal stem cells to cell encapsulation
Publication date: Available online 2 June 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Fahd Hached, Claire Vinatier, Catherine Le Visage, Henri Gondé, Jérôme Guicheux, Gaël Grimandi, Aurélie Billon-Chabaud Osteoarthritis (OA) is a degenerative and inflammatory joint disease that affects the cartilage, subchondral bone, and joint tissues. Although current drug therapies can provide a degree of symptomatic relief from pain, they fail to prevent joint damage. Mesenchymal stem/stromal cells (MSCs) have generated significant interest in terms of medical applicati...
Source: Best Practice and Research Clinical Rheumatology - June 12, 2018 Category: Rheumatology Source Type: research

Wnt signaling as target for the treatment of osteoarthritis
Publication date: Available online 14 April 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Alessandra Stampella, Silvia Monteagudo, Rik Lories Osteoarthritis is a severe and common rheumatic and skeletal disease for which currently no specific drugs are available. The Wnt signaling pathway modulates key biological processes in development, growth, homeostasis, and disease, particularly in the joints and bone. Excessive activation of the Wnt signaling pathway in the articular cartilage has been clearly associated with the onset and severity of osteoarthritis. Hence, targeting Wnt signaling ma...
Source: Best Practice and Research Clinical Rheumatology - April 15, 2018 Category: Rheumatology Source Type: research

Update on research and clinical translation on specific clinical areas from biology to bedside: Unpacking the mysteries of juvenile idiopathic arthritis pathogenesis
Publication date: Available online 1 April 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Jorg van Loosdregt, Femke van Wijk, Berent Prakken, Bas Vastert In the past decades, we have gained important insights into the mechanisms of disease and therapy underlying chronic inflammation in juvenile idiopathic arthritis (JIA). These insights have resulted in several game-changing therapeutic modalities for many patients. However, additional progress still has to be made with regard to efficacy, cost reduction, minimization of side effects, and dose-tapering and stop strategies of maintenance drug...
Source: Best Practice and Research Clinical Rheumatology - April 1, 2018 Category: Rheumatology Source Type: research

Scleroderma in children
Publication date: Available online 27 March 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Francesco Zulian Juvenile scleroderma with its two varieties, juvenile localized scleroderma and systemic sclerosis (SSc), represents the third most frequent rheumatic disease in childhood. In juvenile SSc, new developments have been recently reported in the fields of classification and monitoring. The introduction of new classification criteria for adult SSc has stimulated new ideas on how to improve the performance of the provisional 2007 PRES/ACR/EULAR pediatric criteria. The introduction of a multi...
Source: Best Practice and Research Clinical Rheumatology - March 28, 2018 Category: Rheumatology Source Type: research

Systemic juvenile idiopathic arthritis: New insights into pathogenesis and cytokine directed therapies
Publication date: Available online 21 March 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Manuela Pardeo, Claudia Bracaglia, Fabrizio De Benedetti Systemic juvenile idiopathic arthritis (sJIA) is considered as a polygenic autoinflammatory disease. The prominent systemic clinical features, the marked elevation of inflammatory markers, and the absence of autoantibodies make this disease very different from the other juvenile idiopathic arthritis (JIA) forms. Innate immune mechanisms appear to play a central role: the overproduction of inflammatory cytokines of innate immunity is a typical fea...
Source: Best Practice and Research Clinical Rheumatology - March 21, 2018 Category: Rheumatology Source Type: research

Periodic fever syndromes
Publication date: Available online 11 January 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Helen J. Lachmann Periodic fever syndromes are autoinflammatory diseases. The majority present in infancy or childhood and are characterised by recurrent episodes of fever and systemic inflammation that occur in the absence of autoantibody production or identifiable infection. The best recognised disorders include CAPS, FMF, TRAPS and MKD. Understanding the molecular pathogenesis of these disorders provides unique insights into the regulation of innate immunity. Diagnosis relies on clinical acumen an...
Source: Best Practice and Research Clinical Rheumatology - March 6, 2018 Category: Rheumatology Source Type: research

Genetic interferonopathies: An overview
Publication date: Available online 1 February 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Despina Eleftheriou, Paul A. Brogan Interferonopathies comprise an expanding group of monogenic diseases characterised by disturbance of the homeostatic control of interferon (IFN)-mediated immune responses. Although differing in the degree of phenotypic expression and severity, the clinical presentation of these diseases shows a considerable degree of overlap, reflecting their common pathogenetic mechanisms. Increased understanding of the molecular basis of these Mendelian disorders has led to the i...
Source: Best Practice and Research Clinical Rheumatology - March 6, 2018 Category: Rheumatology Source Type: research

Juvenile idiopathic arthritis-associated uveitis
Publication date: Available online 26 February 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Ethan S. Sen, A.V. Ramanan Juvenile idiopathic arthritis (JIA) is the commonest rheumatic disease in children and JIA-associated uveitis its most frequent extra-articular manifestation. The uveitis is potentially sight-threatening and thus carries a considerable risk of morbidity with associated reduction in quality of life. The commonest form of uveitis seen in association with JIA is chronic anterior uveitis, which is almost always asymptomatic in the initial stages. Therefore, screening for JIA-a...
Source: Best Practice and Research Clinical Rheumatology - March 6, 2018 Category: Rheumatology Source Type: research

Recent therapeutic advances in juvenile idiopathic arthritis
Publication date: Available online 26 February 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Gabriella Giancane, Alessandra Alongi, Silvia Rosina, Jessica Tibaldi, Alessandro Consolaro, Angelo Ravelli Over the past two decades, the management of juvenile idiopathic arthritis (JIA) has been revolutionized by the increased tendency toward early aggressive interventions and the availability of the novel biologic medications. In 2017, three novel randomized controlled trials have evaluated the effectiveness and tolerability of golimumab and tocilizumab in polyarticular JIA, and shown that metho...
Source: Best Practice and Research Clinical Rheumatology - March 6, 2018 Category: Rheumatology Source Type: research

Juvenile-onset systemic lupus erythematosus (jSLE) – Pathophysiological concepts and treatment options
Publication date: Available online 1 March 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Christian M. Hedrich, Eve M.D. Smith, Michael W. Beresford The systemic autoimmune/inflammatory condition systemic lupus erythematosus (SLE) manifests before the age of 16 years in 10–20% of all cases. Clinical courses are more severe, and organ complications are more common in patients with juvenile SLE. Varying gender distribution in different age groups and increasing severity with younger age and the presence of monogenic disease in early childhood indicate distinct differences in the pathophy...
Source: Best Practice and Research Clinical Rheumatology - March 6, 2018 Category: Rheumatology Source Type: research

Juvenile dermatomyositis: Latest advances
Publication date: Available online 10 January 2018 Source:Best Practice & Research Clinical Rheumatology Author(s): Qiong Wu, Lucy R. Wedderburn, Liza J. McCann Registries and biobanks for juvenile dermatomyositis (JDM) have generated statistical power to help understand pathogenesis and determine treatment and long-term outcomes in this rare and heterogeneous disease. Genotype, autoantibodies, muscle histology and early clinical features may predict prognosis and guide personalised treatment. While corticosteroids and disease-modifying anti-rheumatic drugs improve outcomes, there remain children who experience re...
Source: Best Practice and Research Clinical Rheumatology - January 10, 2018 Category: Rheumatology Source Type: research

Childhood systemic vasculitis
Publication date: Available online 23 December 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Erdal Sag, Ezgi Deniz Batu, Seza Ozen Vasculitides are characterized by inflammation of the vessel wall. Most of the vasculitides tend to occur in vessels of a specific size and certain target organs. In this review, we discuss each specific childhood vasculitis according to the latest Chapel Hill Consensus Conference 2012 nomenclature system and the Ankara 2008 classification criteria. We have also reviewed the clinical and laboratory characteristics and the recent treatment recommendations for the...
Source: Best Practice and Research Clinical Rheumatology - December 24, 2017 Category: Rheumatology Source Type: research

Health economic evidence gaps and methodological constraints in low back pain and neck pain: Results of the Research Agenda for Health Economic Evaluation (RAHEE) project
Publication date: December 2016 Source:Best Practice & Research Clinical Rheumatology, Volume 30, Issue 6 Author(s): J.M. van Dongen, J. Ketheswaran, D. Tordrup, R.W.J.G. Ostelo, R. Bertollini, M.W. van Tulder Despite the increased interest in economic evaluations, there are difficulties in applying the results of such studies in practice. Therefore, the “Research Agenda for Health Economic Evaluation” (RAHEE) project was initiated, which aimed to improve the use of health economic evidence in practice for the 10 highest burden conditions in the European Union (including low back pain [LBP] and neck pa...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Atherosclerosis in systemic lupus erythematosus
Publication date: Available online 16 October 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Sara Croca, Anisur Rahman Cardiovascular disease (CVD), comprising coronary heart disease and stroke, is one of the most important causes of death in patients with systemic lupus erythematosus (SLE). The risks of developing both clinical CVD and sub-clinical atherosclerosis are increased in patients with SLE. This increase is not fully explained by traditional cardiovascular risk factors such as smoking, hypertension and elevated cholesterol, and it is believed that immune dysfunction also contribute...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Drivers of the immunopathogenesis in systemic lupus erythematosus
Publication date: Available online 20 October 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Thomas Rose, Thomas Dörner This review summarises a number of current insights into the pathogenesis of SLE. On the basis of the interaction of environmental factors within a predisposed host, a chronic autoimmune process gains function with a positive feed-forward loop between innate and adaptive immunity. A current focus of SLE pathogenesis is on the enhanced production of certain cytokines, such as type I interferons and BLyS/BAFF, suggesting continuous plasmacytoid dendritic and myeloid cell...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

SLE redefined on the basis of molecular pathways
Publication date: Available online 21 October 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Guillermo Barturen, Marta E. Alarcón-Riquelme The implementation of precision medicine requires the recruiting of patients in statistically enough numbers, the possibility of obtaining enough materials, and the integration of data from various platforms, which are all real limitations. These types of studies have been performed extensively in cancer but barely on systemic lupus erythematosus (SLE) or other rheumatic diseases. To consider the practical use of the information obtained from such ...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Symptoms in individuals at risk of rheumatoid arthritis
Publication date: Available online 21 October 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Gurpreet Singh Jutley, Zahira P. Latif, Karim Raza An increasing interest in treating individuals at risk of rheumatoid arthritis (RA) to prevent the development of this chronic condition has focussed attention on the identification of risk factors of this disease. Most patients who develop RA progress through a preceding symptomatic phase that may take the form of arthralgia, palindromic rheumatism or unclassified arthritis before a disease currently classifiable as RA is established. An understandi...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Understanding the role of environmental factors in the development of systemic lupus erythematosus
Publication date: Available online 21 October 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Christine G. Parks, Aline de Souza Espindola Santos, Medha Barbhaiya, Karen H. Costenbader Systemic lupus erythematosus (SLE) is a multisystem disease with a complex etiology. Its risk is higher among women, racial and ethnic minorities, and individuals with a family history of SLE or related autoimmune diseases. It is believed that genetic factors interact with environmental exposures throughout the lifespan to influence susceptibility to developing SLE. The strongest epidemiologic evidence exists f...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

What can palindromic rheumatism tell us?
Publication date: Available online 25 October 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Kulveer Mankia, Paul Emery Palindromic rheumatism (PR) is a syndrome characterised by recurrent, self-resolving inflammatory attacks in and around the joints. An association between PR and rheumatoid arthritis (RA) has long been postulated; a significant proportion of PR patients eventually develop RA and the majority also have anti-CCP antibodies. Therefore, PR is often considered a prodrome of RA. However, the clinical and imaging phenotype of PR has several important distinctions from RA. This sug...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

The contribution of musculoskeletal disorders in multimorbidity: Implications for practice and policy
Publication date: Available online 1 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Stephen J. Duffield, Benjamin M. Ellis, Nicola Goodson, Karen Walker-Bone, Philip G. Conaghan, Tom Margham, Tracey Loftis People frequently live for many years with multiple chronic conditions (multimorbidity) that impair health outcomes and are expensive to manage. Multimorbidity has been shown to reduce quality of life and increase mortality. People with multimorbidity also rely more heavily on health and care services and have poorer work outcomes. Musculoskeletal disorders (MSDs) are ubiquitous i...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Role of interferons in SLE
Publication date: Available online 3 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Anders A. Bengtsson, Lars Rönnblom Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that affects many different organ systems, with excessive production of type I interferons (IFNs) and autoantibodies against nucleic acids as hallmarks. Activation of the type I IFN system in SLE is due to continuous stimulation of plasmacytoid dendritic cells by endogenous nucleic acids, leading to sustained type I IFN production. This is reflected by an overexpression of type I IF...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Chronic musculoskeletal pain and its impact on older people
Publication date: Available online 4 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Fiona M. Blyth, Naomi Noguchi Musculoskeletal conditions are the leading cause of disability worldwide and also have a large impact on many other aspects of older people's health such as low physical activity level, poor mobility, frailty, depression, cognitive impairment, falls and poor sleep quality. Clustering of musculoskeletal pain with other pain conditions is also common, and the number of pain sites is an important prognostic factor. While musculoskeletal pain is usually nociceptive in origin...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Diagnostic and prognostic tests in systemic lupus erythematosus
Publication date: Available online 6 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Natalia Vasquez-Canizares, Dawn Wahezi, Chaim Putterman Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease characterized by autoantibodies directed against numerous self-nuclear antigens. Because of the heterogeneous nature of lupus, it has been challenging to identify markers that are sensitive and specific enough for its diagnosis and monitoring. However, with the sequencing of the human genome, rapid development of high-throughput approaches has allowed for a better un...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

The role of ACPAs in at-risk individuals: Early targeting of the bone and joints
This article summarizes current evidence for the role of RA-related autoantibodies in mediating bone loss. Rheumatoid factor (RF) and antibodies recognizing modified (citrullinated) proteins have been used as diagnostic markers for RA over many years. Their role as pathogenic players, however, has long been unrecognized. Recently, several pieces of evidence suggested that bone-resorbing osteoclasts are highly responsive to RA-related autoantibodies, providing a novel association between autoimmunity and bone. These developments have allowed the unraveling of the underlying mechanisms, which are responsible for the well-kno...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

A review on SLE and malignancy
Publication date: Available online 10 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): May Y. Choi, Kelsey Flood, Sasha Bernatsky, Rosalind Ramsey-Goldman, Ann E. Clarke Systemic lupus erythematosus (SLE) is a chronic, systemic autoimmune disease characterized by autoantibody production, complement activation, and immune complex deposition. It predominantly affects young and middle-aged women. While improvements in the diagnosis and treatment of SLE have altered prognosis, morbidity and mortality rates remain higher than the general population. In addition to renal injury, cardiovascu...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Importance of musculoskeletal health and functional capacity through the life course
Publication date: Available online 15 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Anthony D. Woolf, Maria Crotty, Lynette M. March (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Individuals at risk of rheumatoid arthritis – The evolving story
Publication date: Available online 15 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Paul Emery, Kulveer Mankia, Jackie L. Nam (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Mechanisms of thrombosis in systemic lupus erythematosus and antiphospholipid syndrome
Publication date: Available online 16 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Philip G. de Groot, Bas de Laat The presence of antiphospholipid antibodies is one of the most common acquired risk factors for thrombosis. Antiphospholipid antibodies is a collective term for a set of autoantibodies with closely related but different specificity. Experiments in which isolated patient antibodies were injected into mice have shown that a specific subset of autoantibodies, those directed against the first domain of plasma protein β2-glycoprotein I, can explain the increased risk ...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Preventing weakness and stiffness – A top priority for health and social care
Publication date: Available online 17 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Muir Gray, Kenny Butler With growing evidence that sarcopenia, disability and frailty can be prevented with physical activity, people living with pain, stiffness and weakness due to a musculoskeletal condition should be offered physical activity as a preventive strategy. By changing beliefs and attitudes towards ageing and raising the value and importance of physical activity, disability can be avoided or delayed and the costly burden of social care lessened. The effects of ageing and the effec...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Musculoskeletal health and frailty
Publication date: Available online 20 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Fiona E. McGuigan, Patrik Bartosch, Kristina E. Åkesson Frailty is a consequence of advanced aging, where the frailty phenotype tries to capture overall decline in health. Frailty involves multiple physiological systems that are intrinsically inter-related and with highly complex interactions. Frailty is closely linked to musculoskeletal health; musculoskeletal functioning is a key component in quantifying frailty, while at the same time, frailty is associated with the most common age-related ...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Early intervention to restore function and maintain healthy trajectory
Publication date: Available online 20 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Juan Jover, Lydia Abasolo The health of the global population has undergone rapid transformation. Life expectancy and chronic conditions are increasing, and persons aged 65 years or older have become the fastest growing segment of population. The worldwide picture of disease burden is increasingly defined by disability instead of premature mortality. Population growth, ageing and sedentary lifestyles, particularly in developing countries, will result in a crisis for the population health that requir...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Magnetic resonance imaging in individuals at risk of rheumatoid arthritis
Publication date: Available online 20 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Laura Hunt, Gisela Eugénio, Andrew J. Grainger Individuals with rheumatoid arthritis (RA) benefit from early diagnosis and initiation of therapy. There can be delays in both due to diagnostic uncertainties. Imaging modalities, including magnetic resonance imaging (MRI), can detect inflammation earlier than clinical examination alone in early RA patients. Furthermore, the predictive role of MRI for the future development of RA has recently been explored in ‘at-risk’ individuals. Th...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Fragility Fractures & amp; Their Impact on Older People
Publication date: Available online 20 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Lídia Sànchez-Riera, Nicholas Wilson Osteoporotic fractures, in particular hip and vertebral, are a major health burden worldwide. The majority of these fractures occur in the elderly population, resulting in one of the most important causes of mortality and disability in older ages. Their cost for societies is enormous and is forecast to steadily increase over the coming decades globally. Low bone mineral density (BMD) remains a key preventable risk factor for fractures. Screening and...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Sarcopenia
Publication date: Available online 21 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Nicholas Fuggle, Sarah Shaw, Elaine Dennison, Cyrus Cooper Sarcopenia is a condition that is characterized by loss of muscle mass, muscle strength and muscle functional impairment with ageing. The definition of sarcopenia has been through various permutations; however, an enormous recent breakthrough is the inclusion of the condition in the ICD-10 classification of diseases. This chapter covers the background issues regarding definition before describing the epidemiology of the disease according to ...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Musculoskeletal health conditions among older populations in urban slums in sub-Saharan Africa
Conclusions MSK conditions are salient, and a likely key cause of impaired subjective well-being and functioning among older slum populations in SSA. Further research on determinants and consequences of such conditions in older slum populations is required to inform debate on responses to MSK as part of efforts to reorient SSA health systems to aging and to improve slum health. (Source: Best Practice and Research Clinical Rheumatology)
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Measuring physical capacity and performance in older people
Publication date: Available online 22 November 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Sarah E. Lamb, David J. Keene We highlight the important differences between the concepts of capacity and performance and highlight the development of measures and their application in common conditions encountered in health care practice with older people. A number of expert consensus projects have concluded that mobility, balance, muscle strength and dexterity are core domains for capacity measurement in older people. Instruments with evidence of adequate psychometric properties for the evaluation...
Source: Best Practice and Research Clinical Rheumatology - December 5, 2017 Category: Rheumatology Source Type: research

Treat to target, remission and low disease activity in SLE
Publication date: Available online 13 October 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Eric F. Morand, Marta Mosca Despite improvements in survival, outcomes of contemporary treatment of systemic lupus erythematosus (SLE) are unacceptable. Unlike in many diseases, treat-to-target (T2T) approaches have not been adopted in SLE, owing to a lack of validated targets to treat towards. Therefore, it is a key goal to validate target state definitions such as low disease activity and remission, and test their implementation in clinical practice and clinical trials. In this article, we review r...
Source: Best Practice and Research Clinical Rheumatology - October 14, 2017 Category: Rheumatology Source Type: research

Physiology of ageing of the musculoskeletal system
Publication date: Available online 14 October 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Katalin Boros, Tony Freemont This review aims to provide a summary of current concepts of ageing in relation to the musculoskeletal system, highlighting recent advances in the understanding of the mechanisms involved in the development of age-related changes in bone, skeletal muscle, chondroid and fibrous tissues. The key components of the musculoskeletal system and their functions are introduced together with a general overview of the molecular hallmarks of ageing. A brief description of the normal ...
Source: Best Practice and Research Clinical Rheumatology - October 14, 2017 Category: Rheumatology Source Type: research

Pregnancy in systemic lupus erythematosus and antiphospholipid syndrome
Publication date: Available online 11 October 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Rebecca Fischer-Betz, Christof Specker Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease with a high prevalence in females of childbearing age. Pregnancy in SLE nowadays has favorable outcomes for the majority of women. However, flares of disease activity, preeclampsia, fetal loss, and preterm birth are well-known risks in such pregnancies. Anti-SS-A(Ro)/SS-B(La) antibodies put fetuses at risk for congenital heart block and neonatal lupus. Several risk factors for advers...
Source: Best Practice and Research Clinical Rheumatology - October 12, 2017 Category: Rheumatology Source Type: research

Calcineurin inhibitors in systemic lupus erythematosus
Publication date: Available online 11 October 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Chi Chiu Mok The calcineurin inhibitors (CNIs) belong to a group of immunosuppressive agents that block T-cell activation through the suppression of the calcium/calcimodulin-dependent phosphatase calcineurin. Agents such as cyclosporine A (CSA) and tacrolimus (TAC) have long been used in patients with systemic lupus erythematosus (SLE). TAC is preferred to CSA in SLE because of the lower frequency of cosmetic, hypertensive and dyslipidemic adverse effects. Recent randomised controlled trials have dem...
Source: Best Practice and Research Clinical Rheumatology - October 12, 2017 Category: Rheumatology Source Type: research

Role of the lung in individuals at risk of rheumatoid arthritis
Publication date: Available online 9 October 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Vijay Joshua, Katerini Chatzidionisyou, Anca I. Catrina Antibody-positive (seropositive) rheumatoid arthritis (RA) is a complex multiphasic disease developing in genetically susceptible individuals following environmental challenges (such as smoking). RA-associated autoantibodies can develop several years before any clinical signs of joint inflammation, suggesting that triggering of this autoimmunity occurs outside the joints. Epidemiological, clinical, and molecular studies in seropositive individual...
Source: Best Practice and Research Clinical Rheumatology - October 9, 2017 Category: Rheumatology Source Type: research

Spinal pain and its impact on older people
Publication date: Available online 9 October 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Manuela L. Ferreira, Katie de Luca The term ‘spinal pain’ collectively includes the cervical, thoracic and lumbosacral regions of the spine. The majority of older people experience spinal pain, and with an increasing proportion of older people, the prevalence of spinal conditions are expected to increase in the coming decades. Musculoskeletal conditions of the spine in the older patient commonly include osteoarthritis and spinal stenosis, and the result of these degenerative diseases inclu...
Source: Best Practice and Research Clinical Rheumatology - October 9, 2017 Category: Rheumatology Source Type: research

Understanding cultural influences on back pain and back pain research
Publication date: Available online 30 September 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Nicholas Henschke, Eva Lorenz, Roman Pokora, Zoe A. Michaleff, Jonathan N.A. Quartey, Vinicius Cunha Oliveira Low back pain is highly prevalent and places a considerable burden on individuals, their families and communities. This back pain burden is unequally distributed around the world and within populations. Clinicians and researchers addressing back pain should be aware of the cultural, social and political context of back pain patients and how this context can influence pain perception, disabi...
Source: Best Practice and Research Clinical Rheumatology - September 30, 2017 Category: Rheumatology Source Type: research

Role of ultrasound imaging in individuals at risk of RA
Publication date: Available online 27 September 2017 Source:Best Practice & Research Clinical Rheumatology Author(s): Jackie L. Nam, Maria Antonietta D'Agostino Early diagnosis and treatment improves outcomes for patients with rheumatoid arthritis (RA). Studies have shown that musculoskeletal ultrasound is more sensitive than clinical examination in identifying synovitis. This review aims to address the role of ultrasound in identifying (1) patients with early inflammatory arthritis (IA) at risk of progression to RA and (2) those without clinical synovitis at risk of progression to early IA and therefore early RA....
Source: Best Practice and Research Clinical Rheumatology - September 28, 2017 Category: Rheumatology Source Type: research