Pub Date : 2024-06-05DOI: 10.1038/s41584-024-01131-7
Maria Papatriantafyllou
A wearable smart device that uses reconfigurable electronics and conductive polymer-based microneedles was able to monitor inflammation and provide transdermal drug delivery and electrical stimulation in a rat model of arthritis.
{"title":"Wearable device for RA management?","authors":"Maria Papatriantafyllou","doi":"10.1038/s41584-024-01131-7","DOIUrl":"10.1038/s41584-024-01131-7","url":null,"abstract":"A wearable smart device that uses reconfigurable electronics and conductive polymer-based microneedles was able to monitor inflammation and provide transdermal drug delivery and electrical stimulation in a rat model of arthritis.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 7","pages":"396-396"},"PeriodicalIF":29.4,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-03DOI: 10.1038/s41584-024-01120-w
Frank Buttgereit, Andriko Palmowski, Milena Bond, Giovanni Adami, Christian Dejaco
Patients with inflammatory rheumatic and musculoskeletal diseases (iRMDs) such as rheumatoid arthritis, connective tissue diseases, vasculitides and spondyloarthropathies are at a higher risk of osteoporosis and fractures than are individuals without iRMDs. Research and management recommendations for osteoporosis in iRMDs often focus on glucocorticoids as the most relevant risk factor, but they largely ignore disease-related and general risk factors. However, the aetiopathogenesis of osteoporosis in iRMDs has many facets, including the negative effects on bone health of local and systemic inflammation owing to disease activity, other iRMD-specific risk factors such as disability or malnutrition (for example, malabsorption in systemic sclerosis), and general risk factors such as older age and hormonal loss resulting from menopause. Moreover, factors that can reduce fracture risk, such as physical activity, healthy nutrition, vitamin D supplementation and adequate treatment of inflammation, are variably present in patients with iRMDs. Evidence relating to general and iRMD-specific protective and risk factors for osteoporosis indicate that the established and very often used term ‘glucocorticoid-induced osteoporosis’ oversimplifies the complex inter-relationships encountered in patients with iRMDs. Osteoporosis in these patients should instead be described as ‘multifactorial’. Consequently, a multimodal approach to the management of osteoporosis is required. This approach should include optimal control of disease activity, minimization of glucocorticoids, anti-osteoporotic drug treatment, advice on physical activity and nutrition, and prevention of falls, as well as the management of other risk and protective factors, thereby improving the bone health of these patients. In this Review, the authors argue that the risk of osteoporosis in patients with inflammatory rheumatic and musculoskeletal diseases (iRMDs) is multifactorial, with contributions from iRMD-specific factors, comorbidities, general risk factors and the effects of iRMD therapies such as glucocorticoids.
{"title":"Osteoporosis and fracture risk are multifactorial in patients with inflammatory rheumatic diseases","authors":"Frank Buttgereit, Andriko Palmowski, Milena Bond, Giovanni Adami, Christian Dejaco","doi":"10.1038/s41584-024-01120-w","DOIUrl":"10.1038/s41584-024-01120-w","url":null,"abstract":"Patients with inflammatory rheumatic and musculoskeletal diseases (iRMDs) such as rheumatoid arthritis, connective tissue diseases, vasculitides and spondyloarthropathies are at a higher risk of osteoporosis and fractures than are individuals without iRMDs. Research and management recommendations for osteoporosis in iRMDs often focus on glucocorticoids as the most relevant risk factor, but they largely ignore disease-related and general risk factors. However, the aetiopathogenesis of osteoporosis in iRMDs has many facets, including the negative effects on bone health of local and systemic inflammation owing to disease activity, other iRMD-specific risk factors such as disability or malnutrition (for example, malabsorption in systemic sclerosis), and general risk factors such as older age and hormonal loss resulting from menopause. Moreover, factors that can reduce fracture risk, such as physical activity, healthy nutrition, vitamin D supplementation and adequate treatment of inflammation, are variably present in patients with iRMDs. Evidence relating to general and iRMD-specific protective and risk factors for osteoporosis indicate that the established and very often used term ‘glucocorticoid-induced osteoporosis’ oversimplifies the complex inter-relationships encountered in patients with iRMDs. Osteoporosis in these patients should instead be described as ‘multifactorial’. Consequently, a multimodal approach to the management of osteoporosis is required. This approach should include optimal control of disease activity, minimization of glucocorticoids, anti-osteoporotic drug treatment, advice on physical activity and nutrition, and prevention of falls, as well as the management of other risk and protective factors, thereby improving the bone health of these patients. In this Review, the authors argue that the risk of osteoporosis in patients with inflammatory rheumatic and musculoskeletal diseases (iRMDs) is multifactorial, with contributions from iRMD-specific factors, comorbidities, general risk factors and the effects of iRMD therapies such as glucocorticoids.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 7","pages":"417-431"},"PeriodicalIF":29.4,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141235973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-31DOI: 10.1038/s41584-024-01129-1
Paula S. Ramos, S. Sam Lim
As the pace of genetic discovery has accelerated, so too has the need for clinicians and researchers to acknowledge and understand the impact of language in scientific publications. The use of inaccurate language contributes to systemic bias and eugenic ideologies that remain pervasive in biomedical science, including in rheumatology.
{"title":"Clarity for the language of race, ethnicity and genetic ancestry in rheumatology","authors":"Paula S. Ramos, S. Sam Lim","doi":"10.1038/s41584-024-01129-1","DOIUrl":"10.1038/s41584-024-01129-1","url":null,"abstract":"As the pace of genetic discovery has accelerated, so too has the need for clinicians and researchers to acknowledge and understand the impact of language in scientific publications. The use of inaccurate language contributes to systemic bias and eugenic ideologies that remain pervasive in biomedical science, including in rheumatology.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 8","pages":"453-454"},"PeriodicalIF":29.4,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-21DOI: 10.1038/s41584-024-01127-3
Ennio Lubrano, Fabio Massimo Perrotta
Guidelines for the management of psoriatic arthritis (PsA) need to undergo revision to take on board new evidence, particularly in relation to therapeutics. In March 2024, EULAR published updated recommendations for the pharmacological treatment of PsA, and an expert group published consensus statements intended to complement existing guidelines.
{"title":"Two sides of management recommendations for psoriatic arthritis","authors":"Ennio Lubrano, Fabio Massimo Perrotta","doi":"10.1038/s41584-024-01127-3","DOIUrl":"10.1038/s41584-024-01127-3","url":null,"abstract":"Guidelines for the management of psoriatic arthritis (PsA) need to undergo revision to take on board new evidence, particularly in relation to therapeutics. In March 2024, EULAR published updated recommendations for the pharmacological treatment of PsA, and an expert group published consensus statements intended to complement existing guidelines.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 7","pages":"397-398"},"PeriodicalIF":29.4,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141073841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-17DOI: 10.1038/s41584-024-01126-4
Ali Mobasheri, Richard Loeser
Understanding the molecular endotypes that influence clinical phenotypes is a critical step for the stratification of patients with osteoarthritis (OA) into therapeutic subtypes that can help the development of targeted disease-modifying OA drugs (DMOADs) to provide genuine, long-term clinical benefit.
了解影响临床表型的分子内型是将骨关节炎（OA）患者分层为治疗亚型的关键一步，有助于开发有针对性的疾病修饰性 OA 药物（DMOADs），以提供真正的长期临床益处。
{"title":"Clinical phenotypes, molecular endotypes and theratypes in OA therapeutic development","authors":"Ali Mobasheri, Richard Loeser","doi":"10.1038/s41584-024-01126-4","DOIUrl":"10.1038/s41584-024-01126-4","url":null,"abstract":"Understanding the molecular endotypes that influence clinical phenotypes is a critical step for the stratification of patients with osteoarthritis (OA) into therapeutic subtypes that can help the development of targeted disease-modifying OA drugs (DMOADs) to provide genuine, long-term clinical benefit.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 9","pages":"525-526"},"PeriodicalIF":29.4,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140953364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-16DOI: 10.1038/s41584-024-01123-7
Jason S. Knight, Maria G. Tektonidou
The management of antiphospholipid syndrome is hindered by heterogeneous clinical presentations. Whole-blood transcriptomics have the potential to identify previously unknown disease endotypes, which could inform new treatment strategies. However, such hypothesis-generating data must still account for the results of randomized clinical trials, such as those focused on direct oral anticoagulants in APS.
{"title":"Can transcriptomics guide the management of SLE-associated APS?","authors":"Jason S. Knight, Maria G. Tektonidou","doi":"10.1038/s41584-024-01123-7","DOIUrl":"10.1038/s41584-024-01123-7","url":null,"abstract":"The management of antiphospholipid syndrome is hindered by heterogeneous clinical presentations. Whole-blood transcriptomics have the potential to identify previously unknown disease endotypes, which could inform new treatment strategies. However, such hypothesis-generating data must still account for the results of randomized clinical trials, such as those focused on direct oral anticoagulants in APS.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 8","pages":"457-458"},"PeriodicalIF":29.4,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140949616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-13DOI: 10.1038/s41584-024-01118-4
Rachel C. Nordberg, Benjamin J. Bielajew, Takumi Takahashi, Shuyan Dai, Jerry C. Hu, Kyriacos A. Athanasiou
Articular cartilage was expected to be one of the first successfully engineered tissues, but today, cartilage repair products are few and they exhibit considerable limitations. For example, of the cell-based products that are available globally, only one is marketed for non-knee indications, none are indicated for severe osteoarthritis or rheumatoid arthritis, and only one is approved for marketing in the USA. However, advances in cartilage tissue engineering might now finally lead to the development of new cartilage repair products. To understand the potential in this field, it helps to consider the current landscape of tissue-engineered products for articular cartilage repair and particularly cell-based therapies. Advances relating to cell sources, bioactive stimuli and scaffold or scaffold-free approaches should now contribute to progress in therapeutic development. Engineering for an inflammatory environment is required because of the need for implants to withstand immune challenge within joints affected by osteoarthritis or rheumatoid arthritis. Bringing additional cartilage repair products to the market will require an understanding of the translational vector for their commercialization. Advances thus far can facilitate the future translation of engineered cartilage products to benefit the millions of patients who suffer from cartilage injuries and arthritides. In this Review, the current landscape of tissue engineering for repair of articular cartilage is discussed, with reference to advances in cell sources, bioactive stimuli and the use of scaffolds, and with consideration of the challenges that result from the inflammatory articular environments in osteoarthritis and rheumatoid arthritis.
{"title":"Recent advancements in cartilage tissue engineering innovation and translation","authors":"Rachel C. Nordberg, Benjamin J. Bielajew, Takumi Takahashi, Shuyan Dai, Jerry C. Hu, Kyriacos A. Athanasiou","doi":"10.1038/s41584-024-01118-4","DOIUrl":"10.1038/s41584-024-01118-4","url":null,"abstract":"Articular cartilage was expected to be one of the first successfully engineered tissues, but today, cartilage repair products are few and they exhibit considerable limitations. For example, of the cell-based products that are available globally, only one is marketed for non-knee indications, none are indicated for severe osteoarthritis or rheumatoid arthritis, and only one is approved for marketing in the USA. However, advances in cartilage tissue engineering might now finally lead to the development of new cartilage repair products. To understand the potential in this field, it helps to consider the current landscape of tissue-engineered products for articular cartilage repair and particularly cell-based therapies. Advances relating to cell sources, bioactive stimuli and scaffold or scaffold-free approaches should now contribute to progress in therapeutic development. Engineering for an inflammatory environment is required because of the need for implants to withstand immune challenge within joints affected by osteoarthritis or rheumatoid arthritis. Bringing additional cartilage repair products to the market will require an understanding of the translational vector for their commercialization. Advances thus far can facilitate the future translation of engineered cartilage products to benefit the millions of patients who suffer from cartilage injuries and arthritides. In this Review, the current landscape of tissue engineering for repair of articular cartilage is discussed, with reference to advances in cell sources, bioactive stimuli and the use of scaffolds, and with consideration of the challenges that result from the inflammatory articular environments in osteoarthritis and rheumatoid arthritis.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 6","pages":"323-346"},"PeriodicalIF":33.7,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140915118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.1038/s41584-024-01122-8
Sarah Onuora
Drugs used to treat osteoporosis could slow the progression of osteoarthritis, according to the findings of a study in mice.
一项小鼠研究发现，用于治疗骨质疏松症的药物可以减缓骨关节炎的进展。
{"title":"Bone-modifying drugs slow OA progression","authors":"Sarah Onuora","doi":"10.1038/s41584-024-01122-8","DOIUrl":"10.1038/s41584-024-01122-8","url":null,"abstract":"Drugs used to treat osteoporosis could slow the progression of osteoarthritis, according to the findings of a study in mice.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 6","pages":"319-319"},"PeriodicalIF":33.7,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-03DOI: 10.1038/s41584-024-01110-y
Jason S. Knight, Doruk Erkan
Antiphospholipid syndrome (APS) consists of thrombotic, non-thrombotic and obstetric clinical manifestations developing in individuals with persistent antiphospholipid antibodies (aPL). Although researchers have made progress in characterizing different clinical phenotypes of aPL-positive people, the current approach to clinical management is still mostly based on a ‘one size fits all’ strategy, which is derived from the results of a limited number of prospective, controlled studies. With the 2023 publication of the ACR–EULAR APS classification criteria, it is now possible to rethink APS, to lay the groundwork for subphenotyping through novel pathophysiology-informed approaches, and to set a future APS research agenda guided by unmet needs in clinical management. In this Review, Knight and Erkan consider how the 2023 ACR–EULAR classification criteria for antiphospholipid syndrome (APS) can guide future research to subphenotype APS by understanding its pathophysiology, paving the way for the personalized and proactive management of individuals with APS.
{"title":"Rethinking antiphospholipid syndrome to guide future management and research","authors":"Jason S. Knight, Doruk Erkan","doi":"10.1038/s41584-024-01110-y","DOIUrl":"10.1038/s41584-024-01110-y","url":null,"abstract":"Antiphospholipid syndrome (APS) consists of thrombotic, non-thrombotic and obstetric clinical manifestations developing in individuals with persistent antiphospholipid antibodies (aPL). Although researchers have made progress in characterizing different clinical phenotypes of aPL-positive people, the current approach to clinical management is still mostly based on a ‘one size fits all’ strategy, which is derived from the results of a limited number of prospective, controlled studies. With the 2023 publication of the ACR–EULAR APS classification criteria, it is now possible to rethink APS, to lay the groundwork for subphenotyping through novel pathophysiology-informed approaches, and to set a future APS research agenda guided by unmet needs in clinical management. In this Review, Knight and Erkan consider how the 2023 ACR–EULAR classification criteria for antiphospholipid syndrome (APS) can guide future research to subphenotype APS by understanding its pathophysiology, paving the way for the personalized and proactive management of individuals with APS.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"20 6","pages":"377-388"},"PeriodicalIF":33.7,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140821337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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