Persistent hand pain despite adequate immunosuppression? The distinct value of occupational therapy in the era of biologics
This article describes the meaningful role of occupational therapy and assistive devices in improving the outcomes for patients with inflammatory arthritis. We describe orthoses, assistive devices and adjunctive therapies utilized in inflammatory arthritis. We provide evidence supporting joint protection and occupational therapy as ways to help with these diseases. A multidisciplinary approach including the entire healthcare provider team, including occupational therapists, is essential to providing individualized treatment focusing on maximizing mobility in each patient's daily routine.
Summary
Although larger stud...
Source: Current Opinion in Rheumatology - April 29, 2022 Category: Rheumatology Tags: CLINICAL THERAPEUTICS AND HEMATOLOGIC COMPLICATIONS: Edited by W. Joseph McCune Source Type: research
Therapeutic advances in eosinophilic granulomatosis with polyangiitis
Purpose of review
In recent years, therapeutic advances in eosinophilic granulomatosis with polyangiitis (EGPA) have changed our treatment paradigm. This review will summarize and discuss updates in management of EGPA, with a particular focus on biologic therapies.
Recent findings
The anti-interleukin (IL)-5 agent mepolizumab (the first FDA-approved drug specifically for EGPA) is effective in induction and maintenance of remission particularly in patients with predominantly asthma and allergic manifestations, though efficacy in ANCA-positive, vasculitic disease is unclear; additional anti-IL-5 agents are under s...
Source: Current Opinion in Rheumatology - April 29, 2022 Category: Rheumatology Tags: CLINICAL THERAPEUTICS AND HEMATOLOGIC COMPLICATIONS: Edited by W. Joseph McCune Source Type: research
Advances in the clinical use of hydroxychloroquine levels
Purpose of review
This review summarizes the recent literature exploring hydroxychloroquine levels and their relationship with disease activity and risk of toxicity.
Recent findings
There is no clear correlation between weight-based dosing of hydroxychloroquine and the resulting blood levels of the medication. Recent studies have shown that increased hydroxychloroquine levels are associated with lower lupus disease activity and likely also increased risk of medication toxicity.
Summary
Mounting evidence supports use of hydroxychloroquine levels in clinical practice to document adherence and ensure safety....
Source: Current Opinion in Rheumatology - April 29, 2022 Category: Rheumatology Tags: CLINICAL THERAPEUTICS AND HEMATOLOGIC COMPLICATIONS: Edited by W. Joseph McCune Source Type: research
Editorial introduction
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - April 29, 2022 Category: Rheumatology Tags: EDITORIAL INTRODUCTION Source Type: research
Diagnostic, predictive and prognostic biomarkers in systemic lupus erythematosus: current insights
Purpose of review
Biomarkers for diagnosis, monitoring and prognosis still constitute an unmet need for systemic lupus erythematosus (SLE). Focusing on recent findings, this review summarises the current landscape of biomarkers in lupus.
Recent findings
Urine activated leukocyte cell adhesion molecule (ALCAM) exhibited good diagnostic ability in SLE and lupus nephritis (LN) whereas cerebrospinal fluid neutrophil gelatinase-associated lipocalin (NGAL) showed promise in neuropsychiatric SLE. Urine ALCAM, CD163 and vascular cell adhesion molecule 1 (VCAM-1) may be useful in surveillance of LN. Urine monocyte chemoa...
Source: Current Opinion in Rheumatology - February 1, 2022 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research
Advances in understanding and examining lymphatic function: relevance for understanding autoimmunity
Purpose of review
The aim of this review is to give insights into how novel lymphatics functions may influence autoimmunity.
Recent findings
The lymphatic system connects peripheral tissues to draining lymph nodes to regulate adaptive immunity and directly interfaces with leukocytes in lymph vessels and in the lymph node. Here, we discuss recent findings showing evidence of dysfunctional lymphatics in autoimmune disease, new understanding of how afferent lymphatic regulation can modulate immunity, lymph node lymphatic heterogeneity and how these lymphatics can directly modulate lymphocyte function, how this unde...
Source: Current Opinion in Rheumatology - February 1, 2022 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research
B cells in systemic lupus erythematosus
Purpose of review
New insight into altered B cell distribution including newly identified subsets and abnormalities in systemic lupus erythematosus (SLE) as well as their role in immune protection are summarized in this review.
Recent findings
SLE carries characteristic B cell abnormalities, which offer new insights into B cell differentiation and their disturbances including discoveries of pathogenic B cell subsets and intrinsic B cell abnormalities. A recent study in SLE found that antigen-experienced B cell subsets lacking expression of CD27 and IgD defined by their lack of CXCR5 and CD19low expression are ex...
Source: Current Opinion in Rheumatology - February 1, 2022 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research
Update on gout management: what is old and what is new
Purpose of review
The global burden of gout is rising, as are the prevalence of associated comorbidities, all-cause mortality and societal costs. In this review, we discuss recent advances in epidemiology and treatment strategies for gout.
Recent findings
Genetic factors and obesity are prominent contributors to hyperuricemia and gout, while dietary factors contribute to less variance in serum urate, though can still have some contribution to population attributable risk. A consensus statement by the Gout, Hyperuricemia and Crystal-Associated Disease Network outlined appropriate terminology regarding gout, which...
Source: Current Opinion in Rheumatology - February 1, 2022 Category: Rheumatology Tags: CRYSTAL DEPOSITION DISEASES: Edited by Sara K. Tedeschi Source Type: research
Gout and the COVID-19 pandemic
Purpose of review
This review gives an overview of recently published articles on COVID-19 and gout.
Recent findings
People with gout are likely to be at an increased risk of poor outcomes after COVID-19 infection due to comorbid cardiometabolic conditions. The effects of chronic hyperuricemia on trained immunity, and the hyperinflammatory state induced by gout itself may also play a role. Frequent courses of glucocorticoids for gout flares may be associated with adverse outcomes after COVID-19 infection and reduced immunogenicity to the COVID-19 vaccination. Similarities between the pathophysiology of gout flar...
Source: Current Opinion in Rheumatology - February 1, 2022 Category: Rheumatology Tags: CRYSTAL DEPOSITION DISEASES: Edited by Sara K. Tedeschi Source Type: research
Dual-energy computed tomography in crystalline arthritis: knowns and unknowns
Purpose of review
To give an overview of what can reasonably be considered as known about dual-energy computed tomography (DECT) in crystal-related arthropathies, and what still needs to be explored.
Recent findings
Recent studies suggest an overall superiority of DECT over ultrasound in gout in terms of sensitivity (89 vs. 84%) and specificity (91 vs. 84%), except in early disease. Additional studies are needed to optimize DECT postprocessing settings in order to improve the specificity of the technique and eliminate all artifacts. Evidence has been controversial concerning DECT's ability to detect monosodium u...
Source: Current Opinion in Rheumatology - February 1, 2022 Category: Rheumatology Tags: CRYSTAL DEPOSITION DISEASES: Edited by Sara K. Tedeschi Source Type: research
Review of publications evaluating opioid use in patients with inflammatory rheumatic disease
This article discusses publications assessing the prevalence, efficacy, and safety of opioid analgesics in patients with rheumatic diseases, including rheumatoid arthritis, systemic lupus erythematosus, psoriatic arthritis, ankylosing spondylitis, and systemic sclerosis.
Recent findings
Recent studies show long-term opioid use is common in patients with inflammatory rheumatic disease. We did not find any studies demonstrating improved function or pain control with long-term opioid use in people with rheumatic diseases. Some data shows potential adverse effects including increased risk for fractures and opioid poison...
Source: Current Opinion in Rheumatology - February 1, 2022 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 1, 2022 Category: Rheumatology Tags: EDITORIAL INTRODUCTIONS Source Type: research
Metabolic perturbations in systemic sclerosis
Purpose of review
The aim of this review is to evaluate the recent evidence of the role of metabolism in systemic sclerosis (SSc), highlighting specific aberrations and to appraise the feasibility of targeting these therapeutically.
Recent findings
SSc is an autoimmune disease that is characterised by three facets: vascular problems, inflammation, and fibrosis. The fibrosis primarily affects the skin and lungs and currently, no antifibrotic treatment has been found effective. In recent years a renaissance in metabolism research has begun with renewed vigour in the role of metabolism in disease, particularly in t...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: SPECIAL COMMENTARY Source Type: research
Insights into the molecular landscape of osteoarthritis in human tissues
Purpose of review
To provide an overview of recent developments in the field of osteoarthritis research with a focus on insights gleaned from the application of different -omic technologies.
Recent findings
We searched for osteoarthritis-relevant studies focusing on transcriptomics, epigenomics, proteomics and metabolomics, published since November of 2019. Study designs showed a trend towards characterizing the genomic profile of osteoarthritis-relevant tissues with high resolution, for example either by using single-cell technologies or by considering several -omic levels and disease stages.
Summary
Mul...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research
Bone in osteoarthritis: imaging and interventions
Purpose of review
To review the recent literature on bone in osteoarthritis (OA), with a focus on imaging and intervention studies
Recent findings
Most studies focused on knee OA; hip and hand studies were uncommon. Bone shape studies demonstrated that shape changes precede radiographic OA, predict joint replacement, and have demonstrated high responsiveness. Novel quantitative 3D imaging markers (B-score) have better characterized OA severity, including preradiographic OA status. The addition of computerized tomography-derived 3D metrics has improved the prediction of hip joint replacement when compared to radi...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research
