Reviews & Analysis

This Perspective article discusses the stratification of patients with knee osteoarthritis (OA) in the context of current guidelines, biomarkers and emerging and future developments of targeted treatment. The authors aim to highlight how these novel developments can enhance the stratification of patients with knee OA to improve patient outcomes.

Evidence is emerging that glucagon-like peptide-1 (GLP-1) receptor agonists have anti-inflammatory and chondroprotective properties independent of their effects on weight loss. In this Review, the authors discuss the potential effects of GLP-1 receptor agonists on the incidence, disease activity and progression of various forms of arthritis, as well as practical considerations for their use in this context.

This article provides a comprehensive overview of the epidemiology of spondyloarthritis — including axial spondyloarthritis, psoriatic arthritis and peripheral spondyloarthritis — worldwide, as well as the epidemiology of genetic factors implicated in these diseases.

Analysis of regional variations in the epidemiology of rheumatoid arthritis (RA) over the past 40 years indicates that the age-standardized incidence of RA has increased — and is expected to continue rising — while the mortality and morbidity of the disease are decreasing. As a result, the number of years lived with disability and the overall disease burden attributable to RA have increased and are projected to rise further.

This Review provides a comprehensive overview of emerging therapies for the treatment of systemic sclerosis. The authors highlight novel therapeutic targets and emphasize the need for precision medicine approaches for the effective treatment of this disease.

In this Review article, the potential of cytometry- and single-cell RNA sequencing-based immune profiling for aiding the diagnosis and personalized treatment of rheumatic diseases is discussed.

In systemic lupus erythematosus (SLE), pain is one of the most commonly reported and debilitating symptoms. The authors of this Review highlight the importance of understanding the mechanisms of pain in SLE and addressing pain and pain-associated symptoms in the management of SLE.

Peripheral mechanisms of pain in osteoarthritis include nociceptor sensitization via the function of ion channels and pro-inflammatory molecules, and, potentially, pathways supporting neuronal growth and differentiation within the diseased joint. This Review discusses how neuronal trophism and neurovascular remodelling could be targeted in combination with neuronal de-sensitization or joint re-structuring approaches to reduce osteoarthritic pain.

This Review summarizes clinical effectiveness, health economics and safety data on the parathyroid hormone receptor agonists teriparatide and abaloparatide, discussing potential strategies and drug combinations to achieve best outcomes in patients with osteoporosis.

This Review discusses how alterations in the gut are linked to the development of arthritis. The authors challenge the concept of the ‘leaky gut’ hypothesis, stating that the effects of intestinal permeability and bacterial translocation on the immune system are distinct.

Phenotypic and functional plasticity of macrophages is implicated in the pathophysiology of numerous autoimmune rheumatic diseases. In this Review, the authors discuss the latest insights into this complex and dynamic process and the potential implications for the treatment of these diseases.

Immune-mediated inflammatory diseases (IMIDs) are associated with cancer risk through mechanisms involving disrupted immune tolerance and dysregulated immune responses. Deng et al. investigated how the timing of IMID diagnosis relative to cancer diagnosis affects patient survival outcomes.

Delays in the diagnosis of systemic lupus erythematosus negatively affect the treatment, quality of life and outcomes of affected individuals. In this Perspective, the authors provide an overview of the contributing factors and consequences of diagnostic delay in systemic lupus erythematosus and discuss how this urgent issue should be addressed.

Familial Mediterranean fever (FMF) is a monogenic autoinflammatory disorder with high prevalence in Mediterranean populations. Considerable advances in the management of FMF have been made in the past decade, with respect to the use of biologic drugs and understanding colchicine resistance. The 2024 updated FMF management recommendations are timely and reflect these advances.

This Review provides an update on chondrocyte heterogeneity in cartilaginous tissues in health, disease and senescence focusing on insights gained from single-cell analyses. The authors highlight how single-cell multi-omics techniques could reveal new biomarkers and therapeutic targets for conditions such as osteoarthritis and intervertebral disc degeneration.

The synovial fluid lubricates joints while also collecting molecular mediators from surrounding tissues. This Review highlights how molecular analyses of the synovial fluid might provide information on the progression of knee osteoarthritis and treatment efficacy, and identify potential therapeutic strategies targeting synovial fluid mediators in knee osteoarthritis.

This Review provides an overview of how platelets promote immunothrombosis in rheumatic disease. The authors discuss the different ways in which platelets and immunothrombosis can be targeted for therapeutic intervention.

In this Perspective, the authors and the members of the Integrated Multidisciplinary Paediatric Autoimmunity and Cell Therapy (IMPACT) working group discuss specific considerations for the use of chimeric antigen receptor (CAR) T cell therapies in paediatric patients with rheumatic diseases.

Systemic lupus erythematosus is characterized by altered metabolic profiles and changes in immune cell metabolism. The authors review these changes and discuss how interventions that target metabolic processes might provide treatment options in systemic lupus erythematosus.