Imaging of Joint and Soft Tissue Involvement in Systemic Lupus Erythematosus
AbstractPurpose of ReviewTo highlight the potential uses and applications of imaging in the assessment of the most common and relevant musculoskeletal (MSK) manifestations in systemic lupus erythematosus (SLE).Recent FindingsUltrasound (US) and magnetic resonance imaging (MRI) are accurate and sensitive in the assessment of inflammation and structural damage at the joint and soft tissue structures in patients with SLE. The US is particularly helpful for the detection of joint and/or tendon inflammation in patients with arthralgia but without clinical synovitis, and for the early identification of bone erosions. MRI plays a...
Source: Current Rheumatology Reports - July 16, 2021 Category: Rheumatology Source Type: research

Long-Term Safety of Rituximab (Risks of Viral and Opportunistic Infections)
AbstractPurpose of ReviewWe reviewed the current data on infections associated with rituximab use published over the last 5 years.Recent FindingsNew literature was available on rates of serious infections, Hepatitis B reactivation and screening, and infection with Severe Acute Respiratory Syndrome Coronavirus 2.SummaryRates of infection varied by study and population, however, higher risk of infection in patients with underlying rheumatologic diseases was seen in those who required a therapy switch, had a smoking history, and those undergoing retreatment who had a serious infection with their first course of therapy. With ...
Source: Current Rheumatology Reports - July 16, 2021 Category: Rheumatology Source Type: research

What Has Dual Energy CT Taught Us About Gout?
AbstractPurpose of the ReviewDual energy computed tomography (DECT) scan has emerged as a useful diagnostic tool in the diagnosis of gout over recent years. Here, we review the role of DECT in the context of typical and atypical gout, including its role in identifying extra-articular monosodium urate (MSU) deposition.Recent FindingsDECT has been found to be more accurate than ultrasound in detecting extra-articular MSU deposition in soft tissue. It has the ability to identify axial MSU deposition in gout patients with non-specific back pain. For individuals with no other clear etiology, this potentially implicates MSU as t...
Source: Current Rheumatology Reports - July 14, 2021 Category: Rheumatology Source Type: research

The Role of Antiphospholipid Antibodies in COVID-19
AbstractPurpose of the ReviewElevated levels of anti-phospholipid (aPL) antibodies are the most important criterion in the diagnosis of anti-phospholipid syndrome (APS) and are usually responsible for promoting the risk of thrombotic complications. Now, in the course of the global coronavirus disease 2019 (COVID-19) pandemic, measurable aPL antibodies have also been detected in a noticeable number of patients showing a variety ranging from studies with only isolated positive tests to cohorts with very high positivity. Thus, the question arises as to whether these two different clinical pictures may be linked.Recent Finding...
Source: Current Rheumatology Reports - July 14, 2021 Category: Rheumatology Source Type: research

Advances in Juvenile Spondyloarthritis
AbstractPurposeTo provide an overview of recent studies on pathogenesis, diagnosis, and management of juvenile spondyloarthritis (JSpA).Recent FindingsRecent studies show differences in gut microbiome in patients with JSpA in comparison to healthy controls. There is increased recognition of the impact of the innate immune system on disease pathology. Normative reference on MRI of sacroiliac (SI) joints in children is now available. However, there is significant variability in interpretation of MRI of SI joints in children and a need for standardization. NSAIDs, physical therapy, and Tumor Necrosis Factor Inhibitors (TNFi) ...
Source: Current Rheumatology Reports - July 13, 2021 Category: Rheumatology Source Type: research

Re-Examining Myofascial Pain Syndrome: Toward Biomarker Development and Mechanism-Based Diagnostic Criteria
AbstractPurpose of ReviewWe discuss the need for a mechanism-based diagnostic framework with a focus on the development of objective measures (e.g., biomarkers) that can potentially be added to the diagnostic criteria of the syndrome. Potential biomarkers are discussed in relation to current knowledge on the pathophysiology of myofascial pain syndrome (MPS), including alterations in redox status, inflammation, and the myofascial trigger point (MTrP) biochemical milieu, as well as imaging and neurophysiological outcomes. Finally, we discuss the long-term goal of conducting a Delphi survey, to assess the influence of putativ...
Source: Current Rheumatology Reports - July 8, 2021 Category: Rheumatology Source Type: research

Systematic Review of Antiphospholipid Antibodies in COVID-19 Patients: Culprits or Bystanders?
AbstractPurpose of ReviewCOVID-19 patients have a procoagulant state with a high prevalence of thrombotic events. The hypothesis of an involvement of antiphospholipid antibodies (aPL) has been suggested by several reports. Here, we reviewed 48 studies investigating aPL in COVID-19 patients.Recent FindingsPrevalence of Lupus Anticoagulant (LA) ranged from 35% to 92% in ICU patients. Anti-cardiolipin (aCL) IgG and IgM were found in up to 52% and up to 40% of patients respectively. Anti- β2-glycoprotein I (a β2-GPI) IgG and IgM were found in up to 39% and up to 34% of patients respectively. Between 1% and 12% of pat...
Source: Current Rheumatology Reports - July 3, 2021 Category: Rheumatology Source Type: research

Anatomical Joint Form Variation in Sacroiliac Joint Disease: Current Concepts and New Perspectives
AbstractPurpose of ReviewThe aim of this article is to further the understanding of anatomical variation of the sacroiliac joint (SIJ) within the rheumatological community and point out promising fields of research in the interplay of SIJ anatomy and joint disease.Recent FindingsMechanical strain has long been implicated in onset and progression of axial spondyloarthritis (axSpA). Recent investigations found changes in the pattern of degenerative lesions of the SIJ in the normal population in patients with atypical joint forms. Furthermore, atypical SIJ forms are more prevalent in patients with axial spondyloarthritis and ...
Source: Current Rheumatology Reports - July 3, 2021 Category: Rheumatology Source Type: research

Familial Clustering of Juvenile Psoriatic Arthritis Associated with a Hemizygous FOXP3 Mutation
This report highlights the influence of immune dysregulation in juvenile arthritis. (Source: Current Rheumatology Reports)
Source: Current Rheumatology Reports - July 3, 2021 Category: Rheumatology Source Type: research

COVID-19 and Myositis: What We Know So Far
AbstractPurposeMyositis as a rare manifestation of COVID-19 is only recently being reported. This review examines the current literature on COVID-19-induced myositis focusing on etiopathogenesis, clinical presentations, diagnostic practices, and therapeutic challenges with immunosuppression, and the difficulties experienced by rheumatologists in established myositis in the COVID-19 era.Recent FindingsCOVID-19 is associated with a viral myositis attributable to direct myocyte invasion or induction of autoimmunity. COVID-19-induced myositis may be varied in presentation, from typical dermatomyositis to rhabdomyolysis, and a ...
Source: Current Rheumatology Reports - July 3, 2021 Category: Rheumatology Source Type: research

Imaging in Axial Spondyloarthritis: What is Relevant for Diagnosis in Daily Practice?
AbstractPurpose of ReviewTo explore how imaging may assist diagnosing axial spondyloarthritis in rheumatology practice.Recent FindingsA diagnosis of axial spondyloarthritis is based on pattern recognition by synthesizing clinical, laboratory, and imaging findings. In health care settings providing low threshold access to advanced imaging, sacroiliac joint MRI is the preferred imaging modality in clinically suspected axial spondyloarthritis. In daily routine, the optimum protocol to assess suspected inflammatory back pain combines sacroiliac joint and spine MRI fitting a 30-min slot. Contextual assessment of concomitant str...
Source: Current Rheumatology Reports - July 3, 2021 Category: Rheumatology Source Type: research

Current Understanding of Multisystem Inflammatory Syndrome (MIS-C) Following COVID-19 and Its Distinction from Kawasaki Disease
AbstractPurpose of ReviewIn this article, I have reviewed current reports that explore differences and similarities between multisystem inflammatory syndrome in children (MIS-C) and other known multisystem inflammatory diseases seen in children, particularly Kawasaki disease.Recent FindingsSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a human coronavirus causing the COVID-19 disease which emerged in China in December 2019 and spread rapidly to the entire country and quickly to other countries. Currently, there is a pandemic of SARS-CoV-2 infection that results in 20% of patients admitted to hospital with ...
Source: Current Rheumatology Reports - July 3, 2021 Category: Rheumatology Source Type: research

Wind of Change in the Treatment of Childhood-Onset Takayasu Arteritis: a Systematic Review
AbstractPurpose of ReviewWe lack evidence-based data for the treatment of childhood-onset Takayasu arteritis (c-TA) since it is a rare disease in children. In this systematic literature review, we aimed to evaluate the treatment choices in c-TA patients and integrate our experience for the treatment of our patients in the recent years/in the biologic era.Recent FindingsWe reviewed 24 articles addressing treatments of 413 c-TA patients. Steroids were given to 352 patients (85.2%) as the main immunosuppressive therapy. Other immunosuppressive agents included methotrexate (37.3%), cyclophosphamide (24.5%), azathioprine (16.9%...
Source: Current Rheumatology Reports - July 3, 2021 Category: Rheumatology Source Type: research

Current Epidemiology and Risk Factors for the Development of Hand Osteoarthritis
AbstractPurpose of ReviewHand osteoarthritis (hand OA), the most common peripheral arthritis in the world, is less studied than osteoarthritis (OA) of the knee and hip. However, it is uniquely situated to offer novel insight into OA as a disease process by removing weight-bearing as a confounder of systemic disease mechanisms. Here we review the epidemiology of hand OA and key risk factors for its development.Recent FindingsMounting evidence points to obesity as an important risk factor for hand OA development, with new evidence implicating a role for leptin and serum fatty acids. Disease progression in hand OA and specifi...
Source: Current Rheumatology Reports - July 3, 2021 Category: Rheumatology Source Type: research

MicroRNAs in Axial Spondylarthritis: an Overview of the Recent Progresses in the Field with a Focus on Ankylosing Spondylitis and Psoriatic Arthritis
AbstractPurpose of ReviewTo highlight the recent discoveries and lines of evidence on the role of microRNAs in ankylosing spondylitis (AS) and psoriatic arthritis (PsA), focusing on their expression profiling and mechanisms of action.Recent FindingsAS and PsA are chronic inflammatory musculoskeletal diseases with axial manifestations and represent an excellent model for studying microRNAs contribution to the disease pathogenesis, particularly through immunomodulation, inflammation, and bone remodelling, or their value as candidate diagnostic and prognostic biomarkers.SummaryMicroRNAs are single-stranded nucleotides able to...
Source: Current Rheumatology Reports - July 3, 2021 Category: Rheumatology Source Type: research

Enzymatic Machinery of Ubiquitin and Ubiquitin-Like Modification Systems in Chondrocyte Homeostasis and Osteoarthritis
AbstractPurpose of ReviewTo date, a vast amount of information regarding ubiquitination (Ub) and ubiquitylation-like (Ubl) modification –related mechanisms has been reported in the context of skeletal cell homeostasis and diseases. In this review, we mainly focus on recent findings regarding the contribution of enzymatic machinery that directly adds or removes Ub and Ubl modifications from protein targets in chondrocyte homeostasi s and osteoarthritis (OA) development.Recent FindingsMechanisms that promote homeostasis of articular chondrocytes are crucial for maintaining the integrity of articular joints to prevent o...
Source: Current Rheumatology Reports - July 3, 2021 Category: Rheumatology Source Type: research

Modification of Gut Microbiota in Inflammatory Arthritis: Highlights and Future Challenges
AbstractPurpose of ReviewThis Review evaluates the available information on the modification of the microbiota by diet, prebiotics, probiotics, or drugs and its association with the severity of arthritis in animals and humans and highlights how this modulation could have therapeutic applications in RA.Recent FindingsThe gut microbiota and microbiota-derived metabolites play a role in developing rheumatoid arthritis (RA) in animals and humans, making the intestinal microbiota an exciting novel approach to suppress autoimmunity.SummaryStudies in animal models of RA show that it is possible to modify the intestinal microbiota...
Source: Current Rheumatology Reports - July 3, 2021 Category: Rheumatology Source Type: research

Updates on the Immunopathology in Idiopathic Inflammatory Myopathies
AbstractPurpose of ReviewTo review recent advances in immunopathology for idiopathic inflammatory myopathies, focusing on widely available immunohistochemical analyses.Recent FindingsSarcoplasmic expression of myxovirus resistance protein A (MxA) is specifically observed in all types of dermatomyositis and informs that type I interferons are crucially involved in its pathogenesis. It is a more sensitive diagnostic marker than perifascicular atrophy. Diffuse tiny dots in the sarcoplasm highlighted by p62 immunostaining are characteristically seen in immune-mediated necrotizing myopathy. This feature is linked to a chaperone...
Source: Current Rheumatology Reports - July 1, 2021 Category: Rheumatology Source Type: research

Localized Forms of Vasculitis
AbstractPurpose of ReviewTo provide an updated review on epidemiology, clinical manifestations, diagnostic assessment, treatment, and prognosis of localized vasculitis, following the 2012 Revised International Chapel Hill Consensus Conference Nomenclature on single-organ vasculitis.Recent FindingsLocalized, single-organ vasculitides encompass a group of rare conditions in which there is no evidence of concomitant systemic vasculitis. Most data on this topic derives from case reports and small case series. Although some aspects of these diseases, such as clinical manifestations and histologic findings, have already been ext...
Source: Current Rheumatology Reports - July 1, 2021 Category: Rheumatology Source Type: research

Beyond Neuropsychiatric Manifestations of Systemic Lupus Erythematosus: Focus on Post-traumatic Stress Disorder and Alexithymia
AbstractPurpose of ReviewTo deepen the comprehension of the role of specific psychological conditions in the pathogenesis and in the treatment of systemic lupus erythematosus (SLE). Specifically, the present comprehensive review aims at examining the association between SLE, alexithymia (AT) —a personality construct referring to the inability to identify, describe, and express sensations, emotions, and physical state—and post-traumatic stress disorder (PTSD), to infer potential biological relationships between these psychopathological issues and disease course, and to draw up a rese arch agenda on gray areas of...
Source: Current Rheumatology Reports - July 1, 2021 Category: Rheumatology Source Type: research

Updates on Clinical Trials in Systemic Lupus Erythematosus
AbstractPurpose of ReviewBecause of the complexity of systemic lupus erythematosus (SLE), different approaches are undertaken while investigating potential therapeutic compounds to treat the disease. The purpose of this review is to summarize the results from recent clinical trials, which investigated different compounds for treating SLE.Recent FindingsTargeting B cells and type I interferons constitutes the major focus in recent clinical trials. The potential for therapeutic effects of small molecule inhibition such as JAK, Tyk, and Btk is now being investigated for treating SLE. The immunoregulation of T cell activation ...
Source: Current Rheumatology Reports - July 1, 2021 Category: Rheumatology Source Type: research

Bone Health in Idiopathic Inflammatory Myopathies: Diagnosis and Management
This article provides an update on the most recent advances in epidemiology, pathogenesis, diagnostic procedures, and therapeutic approaches for myositis-associated bone diseases, such as osteoporosis and bone fractures.Recent FindingsIn the recent years, several studies showed that osteoporosis and consequent fractures are a common and frequently underestimated complication in patients with idiopathic inflammatory myopathies (IIM). In younger patients, asymptomatic fractures might present in the early phase of the disease which could increase the risk of development of further fractures. High-risk patients could be select...
Source: Current Rheumatology Reports - July 1, 2021 Category: Rheumatology Source Type: research

Dietary and Lifestyle-Centered Approach in Gout Care and Prevention
AbstractPurpose of reviewWe aim to provide a comprehensive review of the available literature to inform dietary recommendations for patients with gout and hyperuricemia that have the potential to simultaneously lower serum urate and reduce gout morbidity while addressing gout ’s cardiometabolic comorbidities holistically.Recent findingsThe global burden of gout is rising worldwide, particularly in developed nations as well as in women. Patients with gout are often recommended to follow a low-purine (i.e., low-protein) diet to avoid purine-loading. However, such an approach may lead to increased consumption of unhealt...
Source: Current Rheumatology Reports - July 1, 2021 Category: Rheumatology Source Type: research

Reactive Arthritis Update: Spotlight on New and Rare Infectious Agents Implicated as Pathogens
This article presents a comprehensive narrative review of reactive arthritis (ReA) with focus on articles published between 2018 and 2020. We discuss the entire spectrum of microbial agents known to be the main causative agents of ReA, those reported to be rare infective agents, and those reported to be new candidates causing the disease. The discussion is set within the context of changing disease terminology, definition, and classification over time. Further, we include reports that present at least a hint of effective antimicrobial therapy for ReA as documented in case reports or in double-blind controlled studies. Addi...
Source: Current Rheumatology Reports - July 1, 2021 Category: Rheumatology Source Type: research

IgA Vasculitis in Adults: a Rare yet Challenging Disease
AbstractPurpose of ReviewIgA vasculitis (IgAV) is a rare and poorly understood systemic vasculitis in adults. Its diagnosis and treatment remain a challenge. Herein, we review the clinical manifestations, diagnosis, management, and prognosis of IgAV in adults.Recent FindingsThe clinical course of IgAV in adults appears to be different from pediatric IgAV, especially due to its higher risk of evolving into end-stage renal disease. Rising awareness and interest in adult-onset IgA vasculitis has resulted in recent increasing number of publications on different treatment experiences. However, there is still controversy over th...
Source: Current Rheumatology Reports - July 1, 2021 Category: Rheumatology Source Type: research

The Nasal Microbiome in ANCA-Associated Vasculitis: Picking the Nose for Clues on Disease Pathogenesis
AbstractPurpose of ReviewThe onset and progression of small vessel vasculitis associated with anti-neutrophil cytoplasmic antibodies has been linked to microbial infections. Here, we provide a brief overview of the association of nasal colonization ofStaphylococcus aureus with ANCA-associated vasculitis (AAV) and discuss several recent studies mapping the nasal microbiome in AAV patients in particular.Recent FindingsNasal microbiome studies revealed dysbiosis as a common trait in active AAV which tends to normalize upon immunosuppressive treatment and quiescent disease. However, due to differences in study design, patient ...
Source: Current Rheumatology Reports - July 1, 2021 Category: Rheumatology Source Type: research

Correction to: Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking (APS ACTION): 10-Year Update
The original version of this article unfortunately contained mistakes. In addition to the authors, the following members of the group, APS ACTION Executive Committee (Source: Current Rheumatology Reports)
Source: Current Rheumatology Reports - June 23, 2021 Category: Rheumatology Source Type: research

Advances in the Treatment of Behcet ’s Disease
AbstractPurpose of ReviewTo assess current management of Behcet ’s disease (BD). Controversies on therapeutic approaches to different manifestations, whether conventional immunosuppressives (IS) or biologic agents, should be chosen, and options for refractory disease are discussed.Recent FindingsGlucocorticoids are still the main agents for remission-induction and azathioprine the first-line conventional IS in maintenance phase to prevent relapses of major organ involvement. Apremilast is shown to be a safe and effective option approved by the FDA for oral ulcers. Large case series confirmed the efficacy and safety o...
Source: Current Rheumatology Reports - May 20, 2021 Category: Rheumatology Source Type: research

Correction to: Cognitive Impairment in SLE: Mechanisms and Therapeutic Approaches
A Correction to this paper has been published:https://doi.org/10.1007/s11926-021-01021-x (Source: Current Rheumatology Reports)
Source: Current Rheumatology Reports - May 11, 2021 Category: Rheumatology Source Type: research

Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking (APS ACTION): 10-Year Update
AbstractPurpose of ReviewAPS ACTION is an international research network created to design and conduct large-scale, multicenter research in persistently antiphospholipid antibody (aPL) –positive patients. Given the expanding research activities of the network in the last decade since its creation, the purpose of this article is to review the scientific contributions of APS ACTION as well as future directions.Recent FindingsAPS ACTION has achieved increased international collaboration with internal and external investigators for outcome, interventional, and mechanistic antiphospholipid syndrome (APS) studies. This has...
Source: Current Rheumatology Reports - May 1, 2021 Category: Rheumatology Source Type: research

Exogenous miRNA: A Perspective Role as Therapeutic in Rheumatoid Arthritis
AbstractRheumatoid arthritis (RA) is an autoimmune and chronic inflammatory disease that causes joint deformation. Till now several studies has been carried out promising its cure, but curing has not yet achieved to the satisfactory levels. Herbal approach to treat disease by a cross-kingdom mechanism via exogenous miRNA is an emerging trend to target associated genes with RA pathogenesis as a therapeutic potential. The concept of acquired/exogenous miRNA into pathophysiological prospect provides an opportunity to explore inter-species kingdom like regulation of plant miRNAs on human health. The change in gene expression w...
Source: Current Rheumatology Reports - April 30, 2021 Category: Rheumatology Source Type: research

Which Hormones and Contraception for Women with APS? Exogenous Hormone Use in Women with APS
AbstractPurpose of ReviewUse of exogenous estrogen carries significant risk for patients with prothrombotic disorders including those with antiphospholipid antibody (aPL) and antiphospholipid syndrome (APS). This review summarizes current knowledge of contraceptive and other hormone therapies for aPL-positive and APS women and highlights knowledge gaps to guide future research.Recent FindingsStudies support very low risk for most progestin-only contraceptives in patients with increased thrombotic risk, but suggest increased VTE risk with depot-medroxyprogesterone acetate.SummaryHighest efficacy contraceptives are intrauter...
Source: Current Rheumatology Reports - April 30, 2021 Category: Rheumatology Source Type: research

Drivers of Inflammation in Psoriatic Arthritis: the Old and the New
AbstractPurpose of ReviewThe recognition that IL-17 is produced by many lymphoid-like cells other than CD4+ T helper (Th17) cells raises the potential for new pathogenic pathways in IBD/psoriasis/SpA. We review recent knowledge concerning the role of unconventional and conventional lymphocytes expressing IL-17 in human PsA and axSpA.Recent FindingsInnate-like lymphoid cells, namely gamma delta ( γδ) T-cells, invariant natural killer T (iNKT) cells and mucosal-associated invariant T (MAIT) cells, together with innate lymphoid cells (ILCs) are found at sites of disease in PsA/SpA. These cells are often skewed to ...
Source: Current Rheumatology Reports - April 28, 2021 Category: Rheumatology Source Type: research

Neuromyelitis Optica Spectrum Disorders (NMOSD) and Connective Tissue Disease (CTD): an Update for the Rheumatologist
AbstractPurpose of ReviewTo review the pathophysiology, presentation, and treatment of neuromyelitis optica spectrum disorder (NMOSD) and its association with systemic lupus erythematosus (SLE) and Sjogren's syndrome (SS).Recent FindingsNMOSD is an autoimmune disorder of the central nervous system that primarily targets astrocytes. Although the prevalence is unknown, the coexistence of NMOSD and SLE/SS is well-recognized. Patients with both NMOSD and SLE or SS require may require unique approaches to diagnosis and management.SummaryCoexistence of NMOSD and SLE/SS is important for the rheumatologist and neurologist to be ab...
Source: Current Rheumatology Reports - April 28, 2021 Category: Rheumatology Source Type: research

Fatty Acids and Oxylipins in Osteoarthritis and Rheumatoid Arthritis —a Complex Field with Significant Potential for Future Treatments
AbstractPurpose of ReviewOsteoarthritis (OA) and rheumatoid arthritis (RA) are characterized by abnormal lipid metabolism manifested as altered fatty acid (FA) profiles of synovial fluid and tissues and in the way dietary FA supplements can influence the symptoms of especially RA. In addition to classic eicosanoids, the potential roles of polyunsaturated FA (PUFA)-derived specialized pro-resolving lipid mediators (SPM) have become the focus of intensive research. Here, we summarize the current state of knowledge of the roles of FA and oxylipins in the degradation or protection of synovial joints.Recent FindingsThere exists...
Source: Current Rheumatology Reports - April 28, 2021 Category: Rheumatology Source Type: research

ANCA Status or Clinical Phenotype — What Counts More?
AbstractPurpose of ReviewThere is ongoing debate concerning the classification of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. That is, whether classification should be based on the serotype (proteinase 3 (PR3)- or myeloperoxidase (MPO)-ANCA) or on the clinical phenotype (granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA)). To add clarity, this review focused on integration of the most recent literature.Recent FindingsLarge clinical trials have provided evidence that a serology-based risk assessment for relapses is more predictive than distinction based on the phenotype. Research ...
Source: Current Rheumatology Reports - April 28, 2021 Category: Rheumatology Source Type: research

Axial Psoriatic Arthritis
AbstractPurpose of ReviewTo review current understanding of the prevalence, clinical features, outcome measures and recent therapeutic trials in axial psoriatic arthritis (axPsA).Recent FindingsThe prevalence of axPsA is estimated at 40 –50%. However, the definition of axPsA remains unclear, therefore these estimates may be inaccurate. Ax PsA appears to be distinct from ankylosing spondylitis in demographic, clinical, genetic and therapeutic features. Because of the lack of widely accepted definition of axPsA it has been difficul t to design therapeutic trials for this domain of PsA.SummarySeveral studies have demons...
Source: Current Rheumatology Reports - April 28, 2021 Category: Rheumatology Source Type: research

Reactive Arthritis following Bacillus Calmette –Guerin Therapy for Bladder Cancer: a Systematic Literature Review
AbstractPurpose of ReviewIntravesical BCG therapy (ivBCG) is a treatment for bladder cancer that complements surgery and prevents tumor progression. Reactive arthritis (ReA) is a rare osteoarticular manifestation that can complicate this treatment. An updated systematic literature review has been investigated to identify clinical, biological, and therapeutic data of this pathology.Recent FindingsA systematic literature was performed on October 2020 to identify papers published from 2000 to 2020. Study eligibility criteria included case reports, case series, cohort studies, systematic reviews, meta-analysis, and letters to ...
Source: Current Rheumatology Reports - April 28, 2021 Category: Rheumatology Source Type: research

JAK Inhibitors for Axial Spondyloarthritis: What does the Future Hold?
AbstractPurpose of ReviewTo discuss the potential role of JAK inhibitors (JAKis) as a new therapeutic class for the treatment of axial spondyloarthritis (axSpA, including ankylosing spondylitis [AS] and non-radiographic axSpA [nr-axSpA]).Recent FindingsA phase III randomized controlled trial of tofacitinib (a “pan JAKi”) in patients with active AS was found to be superior to placebo in achieving the ASAS20 primary endpoint at week 16 (56.4% and 29.4%,p
Source: Current Rheumatology Reports - April 28, 2021 Category: Rheumatology Source Type: research

Differential Metabolome in Rheumatoid Arthritis: a Brief Perspective
AbstractPurpose of ReviewRheumatoid arthritis (RA) is a chronic autoimmune, inflammatory disease of the synovium that affects the movable joints. It develops due to the infiltration and invasion of the synovial joints by immune cells. Metabolism is anabolic or catabolic chemical reactions occurring in a cell. The biochemical pathways in synovial and immune cells are altered affecting the downstream metabolite formation. Changes in the metabolite levels alter signaling cascades which further intensify the disease. Despite current knowledge of metabolomics, there remain certain features that need to be elucidated to correlat...
Source: Current Rheumatology Reports - April 28, 2021 Category: Rheumatology Source Type: research

Value-Based Healthcare in Rheumatology: Axial Spondyloarthritis and Beyond
AbstractPurpose of ReviewThis review examines axial spondyloarthritis (axSpA) and the wider field of rheumatology through a value-based healthcare (VBHC) lens. VBHC is focused on ensuring patients receive high quality care to improve outcomes and reduce unnecessary costs.Recent FindingsThere are many opportunities to apply the principles of VBHC in axSpA. These include the appropriate utilization of diagnostic investigations, such as HLA-B27 and magnetic resonance imaging, assessing outcomes meaningful to patients, and optimizing care pathways. Multidisciplinary care may improve value, and reduced specialist review and med...
Source: Current Rheumatology Reports - April 28, 2021 Category: Rheumatology Source Type: research

Novel Therapies for ANCA-associated Vasculitis
AbstractPurpose of ReviewThe purpose of this review is to discuss the most recent evidence on the treatment innovations and future prospective in the management of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs).Recent FindingsIn AAV, a growing body of research is available on novel treatment options for remission induction and to clarify some uncertainties concerning the optimal use of available drugs. Efforts are being made to reduce the toxicity associated with high-dose, prolonged glucocorticoids (GC) regimens. Despite major advances in the prognosis of AAV, relapses are still common and the ...
Source: Current Rheumatology Reports - April 28, 2021 Category: Rheumatology Source Type: research

Recent Updates in the Immunopathology of Type 3 Immunity-Mediated Enthesitis
AbstractPurpose of ReviewEnthesitis is a cardinal feature of spondyloarthritis (SpA). Despite increasing available treatments, challenges remain in adequately controlling inflammation and subsequent new bone formation (NBF) in entheses; thus, a better understanding of the immunopathogenesis is warranted.Recent FindingsIncreasing evidence has identified immune cells playing key roles in enthesitis such as γδ T cells and group 3 innate lymphoid cells (ILC3), possibly with site-specific regulatory systems. The presence of T cells producing interleukin (IL)-17 independent of IL-23 in human spinal entheses was recen...
Source: Current Rheumatology Reports - April 24, 2021 Category: Rheumatology Source Type: research

Involvement of Macrophages and Spinal Microglia in Osteoarthritis Pain
AbstractPurpose of ReviewChronic pain in osteoarthritis (OA) is characterized by pain sensitization, which involves both peripheral and central mechanisms. Studies suggest synovial macrophage and spinal microglia are implicated in pain sensitization in OA. We, therefore, reviewed the evidence of whether synovial macrophage and spinal microglia facilitated pain sensitization at diverse levels and how this event occurred in OA.Recent FindingsPeripherally, joint inflammation is now believed to be a source of OA-related pain. Synovial macrophages accumulate in OA inflamed synovium and display a pro-inflammatory phenotype. Abun...
Source: Current Rheumatology Reports - April 24, 2021 Category: Rheumatology Source Type: research

Intersections Between Mitochondrial Metabolism and Redox Biology Mediate Posttraumatic Osteoarthritis
AbstractPurpose of ReviewThis review will cover foundational studies and recent findings that established key concepts for understanding the importance of redox biology to chondrocyte mitochondrial function and osteoarthritis pathophysiology after injury.Recent FindingsArticular chondrocyte mitochondria can be protected with a wide variety of antioxidants that will be discussed within a framework suggested by classic studies. These agents not only underscore the importance of thiol metabolism and associated redox function for chondrocyte mitochondria but also suggest complex interactions with signal transduction pathways a...
Source: Current Rheumatology Reports - April 24, 2021 Category: Rheumatology Source Type: research

Clinical Characteristics of Myositis Associated with Graft-Versus-Host Disease
AbstractPurpose of ReviewRecipients of allogeneic hematopoietic stem cell transplantation (HSCT) are at increased risk for inflammatory myositis; histological subsets reported include dermatomyositis, necrotising myopathy and chronic graft-versus-host disease (cGVHD) –related myositis. Though corticosteroids and various immunosuppressive therapies have been used, there is a lack of consensus guidelines dictating therapy.Recent FindingsRecent evidence suggests the fascia as a preferential target in cGVHD myositis, with conditioning regimens promoting fascial microtrauma. Positron emission tomography (PET) can be a use...
Source: Current Rheumatology Reports - April 24, 2021 Category: Rheumatology Source Type: research

COVID-19 and Disease-Modifying Anti-rheumatic Drugs
AbstractPurpose of ReviewPatients on disease-modifying anti-rheumatic drugs (DMARDs) remain concerned about potential risks of severe COVID-19 outcomes. Meanwhile, several DMARDs have been proposed as COVID-19 therapies.Recent FindingsIn patients with autoimmune diseases, baseline glucocorticoid use is associated with severe COVID-19. While classes of DMARDs (e.g., conventional synthetic, targeted synthetic, and biologic) do not appear to be associated with higher risk, specific medications such as rituximab and sulfasalazine may be associated. Randomized clinical trials (RCTs) show that glucocorticoids reduce mortality in...
Source: Current Rheumatology Reports - April 24, 2021 Category: Rheumatology Source Type: research

Gut Microbiota in Lupus: a Butterfly Effect?
AbstractPurpose of ReviewSystemic lupus erythematosus (SLE) is a prototypic autoimmune disease that typically displays chronic inflammatory tissue damage and miscellaneous circulatory autoantibodies, as well as distinctive type 1 interferon signatures. The etiology of SLE is unclear and currently is attributed to genetic predisposition and environmental triggers. Gut microbiota has recently been considered a critical environmental pathogenic factor in immune-related disorders, and studies are ongoing to uncover the key pathogens and the imputative mechanisms. Fundamental advancements on the role of the microbiota in SLE pa...
Source: Current Rheumatology Reports - April 16, 2021 Category: Rheumatology Source Type: research

Persistent Joint Pain Following Arthropod Virus Infections
AbstractPurpose of ReviewPersistent joint pain is a common manifestation of arthropod-borne viral infections and can cause long-term disability. We review the epidemiology, pathophysiology, diagnosis, and management of arthritogenic alphavirus infection.Recent findingsThe global re-emergence of alphaviral outbreaks has led to an increase in virus-induced arthralgia and arthritis. Alphaviruses, including Chikungunya, O ’nyong’nyong, Sindbis, Barmah Forest, Ross River, and Mayaro viruses, are associated with acute and/or chronic rheumatic symptoms. Identification of Mxra8 as a viral entry receptor in the alphavir...
Source: Current Rheumatology Reports - April 13, 2021 Category: Rheumatology Source Type: research

Cognitive Impairment in SLE: Mechanisms and Therapeutic Approaches
AbstractA wide range of patients with systemic lupus erythematosus (SLE) suffer from cognitive dysfunction (CD) which severely impacts their quality of life. However, CD remains underdiagnosed and poorly understood. Here, we discuss current findings in patients and in animal models. Strong evidence suggests that CD pathogenesis involves known mechanisms of tissue injury in SLE. These mechanisms recruit brain resident cells, in particular microglia, into the pathological process. While systemic immune activation is critical to central nervous system injury, the current focus of therapy is the microglial cell and not the sys...
Source: Current Rheumatology Reports - March 29, 2021 Category: Rheumatology Source Type: research