Raynaud's phenomenon and digital ulcers: advances in evaluation and management
Purpose of review
The aim of this review is to give an update on advances in evaluation and management of systemic sclerosis (SSc)-related Raynaud's phenomenon and digital ulceration, focusing on reports from the last 18 months. The increasing recognition of the huge impact of Raynaud's phenomenon and of digital ulceration on the everyday lives of patients with SSc has sparked enthusiasm internationally to develop better outcome measures and better treatments, and so a review is timely.
Recent findings
There have been recent advances in the development of patient reported outcome instruments [e.g. the Hand Disab...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: RAYNAUD PHENOMENON, SCLERODERMA, OVERLAP SYNDROMES AND OTHER FIBROSING SYNDROMES: Edited by John Varga Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: EDITORIAL INTRODUCTIONS Source Type: research
The impact of the COVID-19 pandemic on the field of pediatric rheumatology
Purpose of review
The purpose of this review is to discuss the clinical management of children with pediatric rheumatic disease (PRD) during the Coronavirus disease of 2019 (COVID-19) pandemic, as well as the unique role of the pediatric rheumatologist during a time of emerging post-COVID inflammatory sequelae including, multisystem inflammatory syndrome in children (MIS-C).
Recent findings
To date, there has been little evidence to suggest that children with PRD, including those on immunomodulatory therapies, are at increased risk for severe COVID-19. Clinical guidance statements have been created to support cl...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: RHEUMATOLOGICAL ASPECTS AND TREATMENTS OF COVID-19: Edited by Rebecca H. Haberman Source Type: research
The role of immunomodulatory medications in the treatment of COVID-19
Purpose of review
Given the role of inflammation in severe forms of COVID-19, glucocorticoids and disease-modifying antirheumatic drugs (DMARDs) have been assessed as potential COVID-19 therapies.
Recent findings
Randomized controlled trials (RCTs) have shown that glucocorticoids reduce mortality in severe COVID-19. RCTs of DMARDs have shown mixed results varying on intervention and inclusion criteria. DMARDs, including colchicine or biologic agents, may improve COVID-19 outcomes in specific patient populations.
Summary
Glucocorticoids are an effective treatment for the management of severe COVID-19. Furt...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: RHEUMATOLOGICAL ASPECTS AND TREATMENTS OF COVID-19: Edited by Rebecca H. Haberman Source Type: research
Is severe COVID-19 a cytokine storm syndrome: a hyperinflammatory debate
Purpose of review
The COVID-19 pandemic is a global public health crisis with considerable mortality and morbidity. A role for cytokine storm and therapeutic immunomodulation in a subgroup of patients with severe COVID-19 was proposed early in the pandemic. The concept of cytokine storm in COVID-19 has been criticised, given the lack of clear definition and relatively modest cytokinaemia (which may be necessary for viral clearance) compared with acute respiratory distress syndrome and bacterial sepsis. Here we consider the arguments for and against the concept of cytokine storm in COVID-19.
Recent findings
Sever...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: RHEUMATOLOGICAL ASPECTS AND TREATMENTS OF COVID-19: Edited by Rebecca H. Haberman Source Type: research
Coronavirus disease 2019: update on coronavirus disease 2019 outcomes and vaccine efficacy in patients with immune-mediated inflammatory disease
Purpose of review
Although the literature to date on COVID-19 outcomes in those with immune-mediated inflammatory disease has been largely reassuring there remain many unanswered questions. These include the impact of specific medications on outcomes and the antibody response after COVID-19 vaccination.
Recent findings
We summarized the current literature related to COVID-19 outcomes in immune-mediated inflammatory diseases in rheumatology, gastroenterology, dermatology, and neurology. Overall, we found either no difference or modest differences in risk for severe COVID-19 for people with immune-mediated disease...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: RHEUMATOLOGICAL ASPECTS AND TREATMENTS OF COVID-19: Edited by Rebecca H. Haberman Source Type: research
Editorial: Rheumatology at the center of coronavirus disease 2019: pathogenesis, treatment, and clinical care
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: RHEUMATOLOGICAL ASPECTS AND TREATMENTS OF COVID-19: Edited by Rebecca H. Haberman Source Type: research
Safety updates in novel therapeutics for pediatric rheumatic disease
Purpose of review
Biologics and novel targeted therapeutics have transformed the management of pediatric rheumatic diseases over the past two decades; however, questions about short-term and long-term safety remain. Safety data gathered from recent clinical trials, long-term extensions of prior trials, registries, and other real-world evidence are summarized here for biologics and novel therapeutics commonly prescribed for pediatric rheumatic diseases.
Recent findings
With nearly 20 years of therapeutic experience, tumor necrosis inhibitors (TNFi) are generally well tolerated, although infections, malignancy, ...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: PEDIATRIC AND HERITABLE DISORDERS: Edited by Polly J. Ferguson Source Type: research
Update in familial Mediterranean fever
Purpose of review
Familial Mediterranean fever (FMF) is the prototypic autoinflammatory disease. Although the gene associated with the disease was identified 24 years ago, we still have to learn about the pathogenesis of its inflammation and the variation in the phenotype. In this review, we discuss some recent findings in FMF, such as changes in our understanding of the genetics, aims to define new criteria, and factors contributing to the disease presentation.
Recent findings
We finally have learned why a mutation causing this disease was selected in ancient times; MEFV gene mutations confer resistance to th...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: PEDIATRIC AND HERITABLE DISORDERS: Edited by Polly J. Ferguson Source Type: research
Haematopoietic stem cell transplantation in paediatric rheumatic disease
Purpose of review
A small proportion of children affected by rheumatic diseases suffer from severe, progressive disease, resistant to conventional antirheumatic therapies and to biologic agents interfering with inflammatory cytokines, costimulatory molecules expressed on immune system cells and intracellular signalling pathways. Adding to the poor prognosis is a high risk from significant morbidity and mortality associated with long-term treatment with multiple, often combined anti-inflammatory and immunosuppressive agents. Carefully selected patients from this unfortunate group may benefit from treatment with haematop...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: PEDIATRIC AND HERITABLE DISORDERS: Edited by Polly J. Ferguson Source Type: research
Clinical features of multisystem inflammatory syndrome in children
Purpose of review
To review diagnosis, clinical characteristics and treatment of multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Recent findings
MIS-C emerged in spring 2020 as a hyperinflammatory syndrome following SARS-CoV-2 exposure in children. Despite growing awareness of MIS-C, diagnosis remains challenging due to the range of phenotypes and severity. Fever accompanied by shock, cardiac dysfunction, gastrointestinal symptoms, or mucocutaneous signs suggestive of Kawasaki disease, especially in the presence of known or suspe...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: PEDIATRIC AND HERITABLE DISORDERS: Edited by Polly J. Ferguson Source Type: research
Updates on interferon in juvenile dermatomyositis: pathogenesis and therapy
Purpose of review
This review provides updates regarding the role of interferon (IFN) in juvenile dermatomyositis (JDM), including comparison to interferonopathies and therapeutic implications.
Recent findings
Transcriptomic and protein-based studies in different tissues and peripheral IFN-α assessment have demonstrated the importance of the dysregulated IFN pathway in JDM. Additional studies have validated IFN-regulated gene and protein expression correlation with disease activity in blood and muscle, with potential to predict flares. Type I and II IFN both are dysregulated in peripheral blood and muscle, with...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: PEDIATRIC AND HERITABLE DISORDERS: Edited by Polly J. Ferguson Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: EDITORIAL INTRODUCTIONS Source Type: research
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 disease duration...
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
