Twenty years of clinical trials in axial spondyloarthritis: what can we learn for the future?
Purpose of review We have now about 20 years of experience with the treatment of axial spondyloarthritis with biologics, which raises the question what we can learn from past experience, and which open questions should be addressed in future investigations. Recent findings Many studies have shown that axSpA patients – both patients in their nonradiological and radiological stage – respond similarly well to biologic treatment and these patients should be seen as having the same disease at different stages. AxSpA respond best to TNF-blocker – and probably also to other biologics – if the ...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research

Patient educational needs and challenges in psoriatic arthritis
Purpose of review To provide an overview of the recent research publications on educational needs of patients with psoriatic arthritis (PsA) and the associated challenges. Recent findings The rate of good treatment adherence in PsA can be as low as 57.7% and successful patient education can help improve treatment adherence. Also, 78.7% of patients who stopped their disease modifying anti-rheumatic drugs during the first wave of the COVID-19 pandemic did so without the advice of their clinician. In delivering educational needs, the aspects of disease process, treatment, self-help measures, managing pain, movement...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research

Janus kinase–signal transducers and activators of transcription cell signaling in Spondyloarthritis: rationale and evidence for JAK inhibition
Purpose of review The Janus kinase–signal transducers and activators of transcription (JAK–STAT) signaling proteins represent a group of intracellular kinase molecules that play a central role in the signaling pathways induced by cytokines, chemokines, and certain growth factors associated with systemic and local inflammation of autoimmune diseases including in Spondyloarthritis (SpA). Here, we will discuss (i) the functional significance of the JAK–STAT kinase cascades in the inflammatory-proliferative processes of SpA and its cellular/molecular mechanisms (ii) progress in the development of oral syn...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research

Intestinal dysbiosis in spondyloarthritis – chicken or egg?
Purpose of review The well-established link between intestinal inflammation and spondyloarthritis (SpA) remains largely unexplained. Recent sequencing technologies have given access to a thorough characterization of the gut microbiota in healthy and disease conditions. This showed that inflammatory bowel disease (IBD) is associated with dysbiosis – i.e., disturbed gut microbiota composition – which may contribute to disease pathogenesis. Whether gut dysbiosis exists in SpA and could contribute to disease development or be a bystander consequence of chronic inflammation is a question of major interest. Re...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research

Out of the shadow of interleukin-17A: the role of interleukin-17F and other interleukin-17 family cytokines in spondyloarthritis
Purpose of review The last decade has witnessed tremendous advances in revealing an important role for the interleukin (IL)-17 cytokine family in the pathogenesis of spondyloarthritis (SpA). Although most attention has been focused on IL-17A, a potential role of other IL-17 family members in inflammation and tissue remodelling is emerging. Herein, I review recent studies covering the role of IL-17B-F cytokines in the pathogenesis of SpA. Recent findings Several recent studies provided new insights into the cellular source, regulation and function of IL-17F. IL-17F/IL-17A expression ratio is higher in psoriatic s...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research

Low-dose computed tomography for axial spondyloarthritis: update on use and limitations
This article reviews what a ldCT is and its use and limitations for imaging axial spondyloarthritis. Recent findings Detection of structural damage in bone with CT is far superior to radiography and ldCT of the sacroiliac joints (SIJ) can now be done at radiation exposure levels equivalent to, or even less than, conventional radiography. ldCT should be considered a ‘first-choice’ test for arthritis imaging, and wherever available, SIJ ldCT may completely replace conventional radiography. Radiation exposure in the spine with ldCT is lower than conventional CT. However, it is unclear whether the additional...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research

Inflammatory back pain: a concept, not a diagnosis
Purpose of review The concept of inflammatory back pain (IBP) describes a cohort of patients with chronic back pain (CBP) who have distinct clinical characteristics, rather than being a diagnosis in and of itself. IBP is a common and important feature of axial spondyloarthritis (axSpA) but this is not the only differential. This review examines the utility of IBP in both primary and secondary care settings. Recent findings There are a number of suggested referral strategies for patients with suspected axSpA that include IBP. These strategies attempt to strike a balance between ensuring potential axSpA patients a...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research

Educational needs and challenges in axial spondyloarthritis
Purpose of review Axial spondyloarthritis (axSpA) affects 0.5–1% of the population in many regions of the world. This review summarizes the challenges in medical education around axSpA with attention to evidence around delayed diagnosis, clinician familiarity with typical axSpA features, such as inflammatory back pain and adherence to accepted management principles. Recent findings Clinicians who commonly manage patients with chronic back pain or other typical axSpA features are not consistently aware of the concept of inflammatory back pain and common extra-spinal manifestations. Further, clinicians may n...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research

Diagnostic delay in axial spondyloarthritis – a past or current problem?
Purpose of review To evaluate recent data on diagnostic delay in axial spondyloarthritis (axSpA), factors affecting the delay, potential ways of early diagnosis improvement, and risks associated with early diagnostic approaches. Recent findings Although axSpA can be diagnosed nowadays within the first months after symptom onset, the diagnostic delay remains with several years still remarkably high in many parts of the world. Female gender, human leukocyte antigen-B27 negativity, and younger age at disease onset are among factors associated with a delayed referral to a rheumatologist and consequently with a large...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research

Editorial introduction
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Role of Janus Kinase inhibitors in rheumatoid arthritis treatment
Purpose of review To review recently published articles on use of Janus Kinase inhibitors (Jaki) in the clinic for rheumatoid arthritis (RA). Recent findings Several Jaki have been approved for RA patients failing csDMARDS. Over the last 2 years, EULAR and ACR have published updated recommendations for the pharmacologic management of RA providing guidance on the utilization of Jaki after csDMARD failure. Clinical trials have been published addressing the efficacy of Jaki monotherapy as patients often choose monotherapy because of a desire to avoid multiple therapies and aggravating adverse events with csDMARDs...
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: RHEUMATOID ARTHRITIS: Edited by Bryant R. England Source Type: research

Impact of rheumatoid arthritis and biologic and targeted synthetic disease modifying antirheumatic agents on cancer risk and recurrence
Purpose of review Several new therapeutic drugs are now available for the management of rheumatoid arthritis (RA). Given that RA has been associated with an increased risk of certain cancers like lymphoma and lung cancer, concern remains about the safety of (newer) immunosuppressants used in RA management as it relates to the risk of cancer. Recent findings Most meta-analyses of randomized clinical trials of tumor necrosis factor inhibitors (TNFi) have not observed an association between TNFi and risk of incident cancer. Studies of non-TNFi biologic disease modifying antirheumatic drugs (bDMARDs) and targeted sy...
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: RHEUMATOID ARTHRITIS: Edited by Bryant R. England Source Type: research

Interstitial lung disease throughout the rheumatoid arthritis disease course
Purpose of review To summarize the current understanding of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) throughout the rheumatoid arthritis (RA) disease course from preclinical to established disease. Recent findings ILD is a serious extra-articular manifestation of RA. Multiple studies have demonstrated a high prevalence of both subclinical and clinical ILD throughout the RA disease course. Investigations of patients without RA have demonstrated an association between RA-related autoantibodies like anticitrullinated protein antibodies (ACPA) and interstitial abnormalities on lung imaging....
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: RHEUMATOID ARTHRITIS: Edited by Bryant R. England Source Type: research

Glucocorticoid and opioid use in rheumatoid arthritis management
Purpose of review Glucocorticoids and opioids are longstanding, common treatments for rheumatoid arthritis (RA) symptoms. High-quality clinical trials have established that glucocorticoids improve outcomes in RA, but debate continues as to whether their benefits outweigh their risks. We reviewed recent studies on patterns of glucocorticoid and opioid prescribing in RA, and associated harms. Recent findings At present, a large proportion of RA patients remain on glucocorticoids and/or opioids long-term. Likelihood and risk of both glucocorticoid and opioid exposure vary across the population, and are influenced b...
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: RHEUMATOID ARTHRITIS: Edited by Bryant R. England Source Type: research

Osteoporosis and fractures in rheumatoid arthritis
Purpose of review Rheumatoid arthritis (RA) is associated with increased risk for osteoporotic fracture. We highlight RA-specific risk factors for bone mineral density (BMD) loss and fractures and considerations regarding the diagnosis and treatment of osteoporosis in patients with RA. Recent findings Anticitrullinated protein antibody (ACPA) positivity, although associated with low BMD in early RA, is not associated with accelerated BMD loss over time when compared to ACPA negative individuals. Studies have found reduced BMD in individuals on low doses of glucocorticoids (GCs). Poor functional status and frailt...
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: RHEUMATOID ARTHRITIS: Edited by Bryant R. England Source Type: research

Telerheumatology: before, during, and after a global pandemic
Purpose of review In early 2020, the COVID-19 global pandemic shifted most healthcare to remote delivery methods to protect patients, clinicians, and hospital staff. Such remote care delivery methods include the use of telehealth technologies including clinical video telehealth or telephone visits. Prior to this, research on the acceptability, feasibility, and efficacy of telehealth applied to rheumatology, or telerheumatology, has been limited. Recent findings Telerheumatology visits were found to be noninferior to in-person visits and are often more time and cost effective for patients. Clinicians and patients...
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: RHEUMATOID ARTHRITIS: Edited by Bryant R. England Source Type: research

COVID-19 and rheumatoid arthritis
Purpose of review The coronavirus disease 2019 (COVID-19) pandemic has caused significant morbidity and mortality worldwide. Patients with rheumatoid arthritis (RA) face unique challenges during the pandemic, including concerns regarding infection risk, drug shortages, limited access to care, social isolation, and mental health. This review will examine the multifaceted impacts of the COVID-19 pandemic on patients living with RA. Recent findings In patients with RA, risk factors for severe COVID-19 outcomes include older age and comorbidities, similar to those in the general population. Glucocorticoids, but not ...
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: RHEUMATOID ARTHRITIS: Edited by Bryant R. England Source Type: research

Practical management strategies for benign hypermobility syndromes
This article describes newer diagnostic measures and assessment of hEDS/HSD manifestations. Evidence supporting physical therapy and occupational therapy is provided, as well as recent updates on assistive devices, compressive garments, orthoses, and surgical interventions. Given patient heterogeneity specific guidance about the amount and type of therapies required to produce a beneficial effect is lacking. Treatment should be individualized, and many of the studies focus on regional joint complaints rather than a whole-body approach. Summary Physical therapy and occupational therapy remain the cornerstone of treat...
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: CLINICAL THERAPEUTICS AND HEMATOLOGIC COMPLICATIONS: Edited by W. Joseph McCune Source Type: research

Treatment for systemic sclerosis-associated interstitial lung disease
Purpose of review This review provides an overview of the current treatments for systemic sclerosis-interstitial lung disease (SSc-ILD) and proposes a conceptual framework for disease management with case scenarios. Recent findings Broad treatment categories include traditional cytotoxic therapies, biologic disease-modifying rheumatic drugs, antifibrotic agents, autologous hematopoietic stem cell transplant, and lung transplantation. The optimal use of each option varies depending on SSc-ILD severity, progression, and comorbidities of individual patients. A high-quality randomized controlled trial demonstrated n...
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: CLINICAL THERAPEUTICS AND HEMATOLOGIC COMPLICATIONS: Edited by W. Joseph McCune Source Type: research

Recent advances in the treatment of neuromyelitis optica spectrum disorders
Purpose of review This review examines recently published randomized placebo-controlled trials for the treatment of neuromyelitis optica spectrum disorders (NMOSD). Recent findings Until recently, treatments for NMOSD were used-off label and had not been subjected to randomized placebo-controlled trials. Increased understanding of the pathophysiology of NMOSD, particularly aquaporin-4-IgG seropositive NMOSD, lead to the investigation of eculizumab, inebilizumab, and satralizumab for maintenance therapy. Eculizumab inhibits the cleavage of the terminal complement protein C5, inebilizumab depletes immune cells of ...
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: CLINICAL THERAPEUTICS AND HEMATOLOGIC COMPLICATIONS: Edited by W. Joseph McCune Source Type: research

The use of mycophenolate mofetil area under the curve
Purpose of review Although mycophenolate mofetil (MMF) has been used successfully to treat a myriad of autoimmune diseases, its complex pharmacokinetics make it difficult to determine the true drug exposure for an individual patient. This review summarizes the body of literature focused on the gold standard measurement of the area under the curve (AUC) of mycophenolic acid (MPA), the active metabolite of MMF. Recent findings Fixed dosing of MMF leads to highly variable drug exposure. Retrospective series have reported improved clinical outcomes when a minimum AUC value from 0 to 12 h (AUC0–12h) ≥30 ...
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: CLINICAL THERAPEUTICS AND HEMATOLOGIC COMPLICATIONS: Edited by W. Joseph McCune Source Type: research

Editorial: Quinacrine: au Revoir or Adieu? This safe and effective drug should be reintroduced
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: CLINICAL THERAPEUTICS AND HEMATOLOGIC COMPLICATIONS: Edited by W. Joseph McCune Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - April 15, 2021 Category: Rheumatology Tags: EDITORIAL INTRODUCTIONS Source Type: research

The latest in systemic lupus erythematosus-accelerated atherosclerosis: related mechanisms inform assessment and therapy
Purpose of Review Accelerated atherosclerosis is a significant comorbidity and the leading cause of death for patients with systemic lupus erythematosus (SLE). It is now apparent that SLE-accelerated atherosclerosis is not driven solely by traditional cardiovascular risk factors, adding complexity to disease characterization and mechanistic understanding. In this review, we will summarize new insights into SLE-accelerated atherosclerosis evaluation, treatment, and mechanism. Recent findings Recent work highlights the need to incorporate inflammatory biomarkers into cardiovascular disease (CVD) risk assessments. ...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research

New lupus criteria: a critical view
Purpose of review To review the validation of the European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) 2019 classification criteria for systemic lupus erythematosus (SLE). Recent findings Positive antinuclear antibodies, which constitute the obligatory entry criterion of the EULAR/ACR criteria, were found in the vast majority of SLE patients worldwide, with 97% (94–100%) of patients antinuclear antibodies positive in studies investigating EULAR/ACR criteria performance. Combined over the publications, EULAR/ACR criteria sensitivity was 92% (range 85–97%). Specificity vari...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research

Cellular aspects of the pathogenesis of lupus nephritis
Purpose of review Lupus nephritis is a common severe manifestation of systemic lupus erythematosus. Despite recent advances in therapeutics and understanding of its pathogenesis, there are still substantial unmet needs. This review discusses recent discoveries in these areas, especially the role of tubulointerstitial inflammation (TII) in lupus nephritis. Recent findings Non-white ethnicity is still a major risk and poor prognostic factor in lupus nephritis. TII and fibrosis have been found to be associated with worse renal outcome but the current lupus nephritis treatment guidelines and trials are based on the ...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research

Update on the cellular pathogenesis of lupus
Purpose of review Aberrations in the innate and in the adaptive arms of the immune system play both important roles in the initiation and progression of systemic lupus erythematosus (SLE). The aim of this study was to provide an update on the most recent findings on the cellular pathogenesis of SLE. Our overview focused particularly on results obtained over the last 18 months. Recent findings Recent observations have provided an improved understanding of the importance of low-density granulocytes, a highly proinflammatory subset of neutrophils. We also highlighted in this work recent descriptions of the various ...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research

New therapeutic approaches in systemic lupus erythematosus
Purpose of review This review gives an overview of the recently published clinical trials in systemic lupus erythematosus (SLE). Recent findings Our continuously improving understanding of the cellular and molecular mechanisms, which are involved in the pathogenesis of SLE, has inspired the performance of multiple clinical trials in an attempt to modify recognized targets. Here, we summarize results obtained from recent trials, which used monoclonal antibodies blocking cytokines, blockers of costimulatory molecules or deleting immune cells, small drug inhibitors of kinases and replenishment of cytokines. Summ...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research

Immunopathogenesis of skin injury in systemic lupus erythematosus
Purpose of review Skin injury is the most common clinical manifestation of SLE and is disfiguring, difficult to treat, and incompletely understood. We provide an overview of recently published articles covering the immunopathogenesis of skin injury in SLE Recent findings Skin of SLE has an inherent susceptibility to apoptosis, the cause of which may be multifactorial. Chronic IFN overexpression leads to barrier disruption, infiltration of inflammatory cells, cytokine production, and release of autoantigens and autoantibody production that result in skin injury. Ultraviolet light is the most important CLE trigger...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research

Double-negative T cells in autoimmune diseases
Purpose of review TCRαβ+CD4-CD8- double-negative T (DNT) cells, a principal subset of mature T lymphocytes, have been closely linked with autoimmune/inflammatory conditions. However, controversy persists regarding their ontogeny and function. Here, we present an overview on DNT cells in different autoimmune diseases to advance a deeper understanding of the contribution of this population to disease pathogenesis. Recent findings DNT cells have been characterized in various chronic inflammatory diseases and they have been proposed to display pathogenic or regulatory function. The tissue location of DNT ...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research

COVID-19 and autoimmune diseases
We present a review of the association between COVID-19 and autoimmune diseases, focusing on similarities in immune responses, cross-reactivity of SARS-CoV-2, the development of autoimmune diseases in COVID-19 patients and the risk of COVID-19 infection in patients with preexisting autoimmune conditions. (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research

Medications for gout and its comorbidities: mutual benefits?
Purpose of review To review recent literature with relevance to the management of multimorbid patients with gout, i.e., gout medication repurposed for comorbidities and vice versa. Recent findings Adding to the previous success of interleukin-1 inhibition, two trials on low-dose colchicine's role in cardiovascular disease (CVD) demonstrated potential benefits in patients with or without gout. In Colchicine Cardiovascular Outcomes Trial, a composite CVD endpoint was reduced by 23% among patients who had experienced a recent myocardial infarction. In Low-Dose Colchicine 2, the composite CVD endpoint was reduced 31...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: CRYSTAL DEPOSITION DISEASES: Edited by Sara K. Tedeschi Source Type: research

The role of diet in hyperuricemia and gout
Purpose of review Although gout's cardinal feature is inflammatory arthritis, it is closely associated with insulin resistance and considered a manifestation of the metabolic syndrome. As such, both gout and hyperuricemia are often associated with major cardiometabolic and renal comorbidities that drive the persistently elevated premature mortality rates among gout patients. To that end, conventional low-purine (i.e., low-protein) dietary advice given to many patients with gout warrant reconsideration. Recent findings Recent research suggests that several healthy diets, such as the Mediterranean or Dietary Appro...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: CRYSTAL DEPOSITION DISEASES: Edited by Sara K. Tedeschi Source Type: research

Adherence to gout guidelines: where do we stand?
Purpose of review Although gout is a common, well-recognized, and extensively researched rheumatologic disease, it continues to be underappreciated and undertreated. Although the prevalence of gout has been rising over the past several decades, adherence to urate lowering therapy continues to be suboptimal. Recent studies have underscored the potential success of guideline-directed therapy. Recent findings Adherence to gout treatment continues to be suboptimal according to multinational metaanalyses. Moreover, studies measuring adherence are prone to overestimation and each methodologic approach has intrinsic li...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: CRYSTAL DEPOSITION DISEASES: Edited by Sara K. Tedeschi Source Type: research

Scleroderma epidemiology update
Purpose of review Systemic sclerosis (scleroderma, SSc) is a rare multisystem autoimmune disease characterized by autoantibodies, vasculopathy, and fibrosis of the skin and internal organs. This review aims to provide an overview and summary of the recent epidemiological studies in systemic sclerosis. Recent findings Global trends of scleroderma demonstrate greater prevalence of SSc in European, North, and South American patients compared with East Asian patients. However, the greatest prevalence (47 in 100 000), was found among the indigenous peoples in Canada. Phenotypical differences exist depending on the ...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: EPIDEMIOLOGY AND HEALTH-RELATED SERVICES: Edited by Kenneth G. Saag Source Type: research

Racial, ethnic, and healthcare disparities in rheumatoid arthritis
Purpose of review This review highlights the available data describing racial and ethnic health disparities among patients with rheumatoid arthritis in the United States from an epidemiological, disease activity, and wider socioeconomic standpoint. Recent findings Despite centralized government initiatives to include more underrepresentative minority populations into research, many of the studies that examined rheumatoid arthritis still fail to include sizeable cohorts of races or ethnic groups other than whites. Evidence is slowly mounting that individual, provider, and system-level barriers exist and contribut...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: EPIDEMIOLOGY AND HEALTH-RELATED SERVICES: Edited by Kenneth G. Saag Source Type: research

Global research collaboration in a pandemic-challenges and opportunities: the COVID-19 Global Rheumatology Alliance
Purpose of review This review discusses the coronavirus disease-2019 (COVID-19) Global Rheumatology Alliance (GRA), the reason for its formation, the challenges with running the registry, and future opportunities for global collaborative research in rheumatology. Recent findings The GRA has been successful in collecting and publishing a large volume of case data on patients with rheumatic disease with COVID-19. In addition, the GRA has published reviews, opinion pieces, and patient-directed summaries of research to further assist in disseminating timely and accurate information about COVID-19 in rheumatic diseas...
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: EPIDEMIOLOGY AND HEALTH-RELATED SERVICES: Edited by Kenneth G. Saag Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - February 10, 2021 Category: Rheumatology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Recent advances in targeted drug delivery for treatment of osteoarthritis
Purpose of review Osteoarthritis is associated with severe joint pain, inflammation, and cartilage degeneration. Drugs injected directly into intra-articular joint space clear out rapidly providing only short-term benefit. Their transport into cartilage to reach cellular targets is hindered by the tissue's dense, negatively charged extracellular matrix. This has limited, despite strong preclinical data, the clinical translation of osteoarthritis drugs. Recent work has focused on developing intra-joint and intra-cartilage targeting drug delivery systems (DDS) to enable long-term therapeutic response, which is presented ...
Source: Current Opinion in Rheumatology - November 30, 2020 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research

Role of adipose tissues in osteoarthritis
Purpose of review Epidemiologic studies reveal that the link between obesity and osteoarthritis cannot be uniquely explained by overweight-associated mechanical overload. For this reason, much attention focuses on the endocrine activity of adipose tissues. In addition to the systemic role of visceral and subcutaneous adipose tissues, many arguments highlight the involvement of local adipose tissues in osteoarthritis. Recent findings Alteration in MRI signal intensity of the infrapatellar fat pad may predict both accelerated knee osteoarthritis and joint replacement. In this context, recent studies show that mese...
Source: Current Opinion in Rheumatology - November 30, 2020 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research

Posttraumatic osteoarthritis: what have we learned to advance osteoarthritis?
Purpose of review Current thinking in the study of posttraumatic osteoarthritis (PTOA) is overviewed: the osteoarthritis which follows acute joint injury. The review particularly highlights important publications in the last 18 months, also reflecting on key older literature, in terms of what have we have we learned and have yet to learn from PTOA, which can advance the osteoarthritis field as a whole. Recent findings PTOA is a mechanically driven disease, giving insight into mechanical drivers for osteoarthritis. A mechanosensitive molecular tissue injury response (which includes activation of pain, degradative...
Source: Current Opinion in Rheumatology - November 30, 2020 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research

The transition from enthesis physiological responses in health to aberrant responses that underpin spondyloarthritis mechanisms
Purpose of review Despite immunology and translational therapeutics advances in inflammatory arthritis over the past two decades, the enthesis, which is the epicentric of the spondyloarthritis family pathological process, retains many mysteries because of tissue inaccessibility that hampers direct immune study. As entheses are subject to almost continuous mechanical stress and spondyloarthritis is linked to microdamage or injury and joint stress, it is cardinal to understand the physiological changes occurring within the entheses not only to be able to differentiate disease from health but also to understand the transi...
Source: Current Opinion in Rheumatology - November 30, 2020 Category: Rheumatology Tags: MEDICAL PHYSIOLOGY AND RHEUMATIC DISEASES: Edited by Jose U. Scher Source Type: research

Rheumatology in the era of precision medicine: synovial tissue molecular patterns and treatment response in rheumatoid arthritis
Purpose of review A critical unmet need in rheumatoid arthritis (RA) is the identification of biomarkers that predict which of the available medications will be most effective for an individual in order to lower disease activity sooner than is afforded by the current treat-to-target approach. Here we will discuss recent reports examining the potential for synovial tissue molecular, cellular, and spatial profiling in defining objective measures of treatment response and therein developing personalized medicine for RA. Recent findings Recent high-dimensional molecular profiling of RA synovium has provided unpreced...
Source: Current Opinion in Rheumatology - November 30, 2020 Category: Rheumatology Tags: MEDICAL PHYSIOLOGY AND RHEUMATIC DISEASES: Edited by Jose U. Scher Source Type: research

Coronavirus 2019: clinical and neuropathological aspects
Purpose of review To understand the role of postinfectious autoimmune vascular inflammation in the pathogenesis of coronavirus disease 2019-related neurological illness caused by the novel severe acute respiratory syndrome coronavirus 2 virus and its effects on the brain in children and adults. Recent findings There are a very small number of postmortem neuropathological series of coronavirus disease 2019-related cerebrovascular and parenchymal disease. However, they fall into at least three major categories, with the majority manifesting those of terminal hypoxia, and others demonstrating inflammatory vascular ...
Source: Current Opinion in Rheumatology - November 30, 2020 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

Intracranial vessel wall imaging
Purpose of review To give an overview regarding the potential usefulness of vessel wall imaging (VWI) in distinguishing various intracranial vascular diseases, their common imaging features, and potential pitfalls. Recent findings VWI provides direct visualization of the vessel wall and allows the discrimination of different diseases such as vasculitis, atherosclerosis, dissection, Moyamoya disease, and reversible cerebral vasoconstriction syndrome. Recent studies showed that concentric and eccentric involvement in the vessel wall, as well as the enhancement pattern were found important for the distinguishing th...
Source: Current Opinion in Rheumatology - November 30, 2020 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

Aortitis: an update
Purpose of review Aortitis is the inflammation of the aorta due to various causes. Clinical presentations vary as well as the imaging findings. Exact pathogenetic mechanisms or triggering factors, as well as the best diagnostic and monitoring modalities and treatment strategies, are yet to be elucidated. We reviewed recent studies in aortitis and associated diseases. Recent findings Multiple cohort studies reporting long-term outcomes in patients with noninfectious aortitis were recently published. Comparative features of isolated aortitis were described. Six angiographic clusters for giant cell arteritis and Ta...
Source: Current Opinion in Rheumatology - November 30, 2020 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

Cerebral vasculitis associated with drug abuse
Purpose of review To review understand the epidemiology, background, neuropharmacology, and histopathology of literature verified cases, and likely etiopathogenic mechanisms. Recent findings There are only a handful of histologically confirmed patients in the literature with cerebral vasculitis because of drug abuse. Summary There is little justification for invasive laboratory investigation given the ready availability of highly accurate vascular neuroimaging techniques to dictate management, which usually rests upon avoidance of further exposure and minimizing the secondary neurotoxic effects of the abu...
Source: Current Opinion in Rheumatology - November 30, 2020 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

An update on the microbiome in vasculitis
Purpose of review To summarize recent evidence regarding the presence and potential role of the microbiome in systemic vasculitides. Recent findings Microbiomic descriptions are now available in patients with small, medium and large vessel vasculitis. The majority of studies have evaluated gastrointestinal inhabitants, with a smaller number of studies describing the nasal, pulmonary or vascular microbiomes. Most published studies are observational and cross-sectional. Dysbiosis is seen frequently in vasculitis patients with reduced microbial diversity observed in nasal, fecal and vascular samples compared with d...
Source: Current Opinion in Rheumatology - November 30, 2020 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

Management of primary vasculitides with biologic and novel small molecule medications
Purpose of review Vasculitides can affect small, medium and/or large vessels, leading to end-organ damage, decreased quality of life and death. Glucocorticoids remain the backbone of treatment for systemic vasculitis but are associated with numerous toxicities. In recent years, the efficacy of glucocorticoid-sparing biologic and novel small molecule therapies has been demonstrated. Recent findings In giant cell arteritis, tocilizumab was superior to glucocorticoid monotherapy in maintenance remission and cumulative glucocorticoid exposure and is now approved for the treatment of giant cell arteritis. In addition...
Source: Current Opinion in Rheumatology - November 30, 2020 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

Cryoglobulinemic vasculitis: pathophysiological mechanisms and diagnosis
Purpose of review Cryoglobulins (CG) are immunoglobulins that precipitate in the cold, and dissolve at 37°C. In vivo, in cold exposed tissues and organs, they can induce vasculitis and occlusive vasculopathy after deposition on vascular endothelium under low temperature and high concentration conditions. Clinical manifestations are cutaneous (purpura, ulcers, vasomotor symptoms, and livedo reticularis), rheumatological (arthralgia and arthritis), and peripheral neuropathy (paresthesia and pain in the lower limbs). In profound organs such as the kidneys, CG deposition is less temperature-dependent, favored by local ...
Source: Current Opinion in Rheumatology - November 30, 2020 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research