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 of TN...
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 bee...
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 Type-17 pr...
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 demonstrat...
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< 0.0001, phase II trials of AS). Upadacitinib, a JAK1 inhibitor, has also been evaluated in a phase III trial for its efficacy and safety in AS. The primary endpoint,...
Source: Current Rheumatology Reports - April 28, 2021 Category: Rheumatology Source Type: research
