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Current Rheumatology Reports

Hillary W Garner, Daniel E Wessell
PURPOSE OF REVIEW: Gout is the most common inflammatory arthritis and is increasing in prevalence and incidence in many countries worldwide. Accurate diagnosis is important to direct treatment that may include chronic medication. Burden quantification and treatment monitoring are key in the effective care of patients with gout. This review highlights the positive impact of dual-energy computed tomography (DECT) on the evaluation of gout patients and discusses common imaging artifacts that limit this imaging modality...
November 13, 2018: Current Rheumatology Reports
Annaliese Tisseverasinghe, Christine Peschken, Carol Hitchon
PURPOSE OF REVIEW: Optimal management of anxiety and mood disorders in patients with systemic lupus erythematosus (SLE) is limited by an incomplete understanding of their pathophysiology and a lack of treatment guidelines. This review aims to critically synthesize recent literature on these conditions in adults with SLE, focusing on their etiology, assessment, and management. RECENT FINDINGS: Along with psychosocial factors, there is growing evidence for a bidirectional interaction between inflammatory pathways and SLE-associated anxiety and mood disorders...
November 12, 2018: Current Rheumatology Reports
Laura Chadwick, Sizheng Zhao, Eduardo Mysler, Robert J Moots
PURPOSE OF REVIEW: Etanercept was the first tumour necrosis factor inhibitor approved to treat rheumatoid arthritis (RA) in the United States (US) and Europe. The recent patent expiration of the etanercept originator ENBREL in Europe has facilitated the development of biosimilar products, creating the prospect of reduced treatment costs. In this article, we review the original trials for etanercept in RA to facilitate critical appraisal of biosimilar trial data. RECENT FINDINGS: Two etanercept biosimilars are currently approved in Europe and/or the US, SB4 (Benepali) and GP2015 (Erelzi), having met the pre-specified equivalence criteria for biosimilarity...
November 9, 2018: Current Rheumatology Reports
S A Kerrigan, I B McInnes
PURPOSE OF REVIEW: Given the recent increase in the profile and use of Janus kinase inhibitors (JAKinibs) in adult patients with rheumatic diseases, we aimed to review the current evidence accruing for use in paediatric rheumatology patients. RECENT FINDINGS: Significant advances have been made in the management of rheumatic diseases in the past two decades. The introduction of biologic agents in both adults and children has provided significant improvements to patient outcomes and led to better quality of life...
November 8, 2018: Current Rheumatology Reports
Ismail Sari, Nigil Haroon
PURPOSE OF REVIEW: Pain, functional limitation, and spinal damage are the three main domains that have significant impact on various aspects of axial spondyloarthritis (axSpA). RECENT FINDINGS: Several randomized controlled trials (RCTs) showed a beneficial effect of non-steroid ant-inflammatory drugs (NSAIDs) and biologic treatments on pain and function. The effect of available treatments on spinal damage is still of interest and is being studied. In this article, we review the literature on radiographic progression in axSpA...
November 8, 2018: Current Rheumatology Reports
Alessandra Palmisano, Federica Maritati, Augusto Vaglio
PURPOSE OF REVIEW: We aim to review traditional concepts and recent developments on the nosology, pathophysiology, clinical phenotypes and treatment of chronic periaortitis (CP). RECENT FINDINGS: CP is a rare disorder hallmarked by a periaortic fibro-inflammatory tissue. It can present as an isolated disease, but it can also be associated with other autoimmune and fibro-inflammatory lesions (e.g., fibrosing mediastinitis, sclerosing pancreato-cholangitis) that are part of the spectrum of IgG4-related disease...
November 5, 2018: Current Rheumatology Reports
Silvio Romano, Elisa Salustri, Piero Ruscitti, Francesco Carubbi, Maria Penco, Roberto Giacomelli
PURPOSE OF THE REVIEW: An increased prevalence of cardiovascular risk factors in rheumatoid arthritis (RA) is reported. The absolute cardiovascular risk in RA patients is higher than in the general population, and although the RA prognosis has gradually improved, premature cardiovascular (CV) mortality remains a matter of fact. The purpose of this review is to shed light on CV and metabolic involvement in RA, with the aim of defining its best management. RECENT FINDINGS: Multiple lines of evidence have revealed common mechanisms behind inflammatory and CV diseases and clarified the metabolic and CV pathways involved in RA and the effects of different pharmacological treatments...
November 5, 2018: Current Rheumatology Reports
Siamak Moghadam-Kia, Chester V Oddis, Rohit Aggarwal
PURPOSE OF REVIEW: Anti-melanoma differentiation-associated gene 5 (anti-MDA5) is a novel and highly specific myositis-associated autoantibody, which defines a unique phenotype among patients with dermatomyositis (DM). RECENT FINDINGS: Anti-MDA5 was originally characterized in Japan in DM patients with hallmark cutaneous features and no proximal muscle weakness and termed clinically amyopathic DM (CADM). Anti-MDA5 has characteristic cutaneous manifestations which include tender palmar papules and cutaneous ulcerations, along with an increased frequency of interstitial lung disease (ILD) that can be rapidly progressive (RPILD) and fatal...
October 31, 2018: Current Rheumatology Reports
Feng Pan, Graeme Jones
PURPOSE OF REVIEW: Pain is the most prominent symptom in osteoarthritis. Pain experience is a complex and multifactorial phenomenon. This review, therefore, offers a brief overview of the literature on factors from main pain dimensions and summarizes current evidence for identifying pain phenotypes in knee osteoarthritis. RECENT FINDINGS: Peripheral structural damage has been traditionally considered a source of pain and this has strengthened with MRI studies; however, a discordance between structural damage and pain severity suggests individual variations in pain presentation which may be determined by genetic, environmental (obesity), psychological, and neurological factors...
October 31, 2018: Current Rheumatology Reports
Lihi Eder, Sibel Zehra Aydin
PURPOSE OF REVIEW: Heterogeneity is a hallmark of PsA as musculoskeletal inflammation can affect different tissues including the synovial joint, tendons, entheses, bursa, and bone. RECENT FINDINGS: Relying on clinical examination for investigating underlying mechanisms in PsA is limited by the inherent inaccuracies of examination of the joints, enthesis, and spine. In addition, unlike synovial-centered diseases, histology is hard to obtain for the entheses and spine, limiting the knowledge for different manifestations of PsA...
October 29, 2018: Current Rheumatology Reports
Rebecca Haberman, Lourdes M Perez-Chada, Joseph F Merola, Jose Scher, Alexis Ogdie, Soumya M Reddy
PURPOSE OF REVIEW: Despite a robust therapeutic landscape, significant gaps exist in the quality of care of psoriatic disease. Thus, an improved understanding of the challenges in providing quality care and the implementation of effective strategies to overcome them is needed. In this review, we summarize the burden of psoriatic disease, discuss the challenges in the care of psoriatic patients, and outline how combined dermatology-rheumatology clinics bridge many of these gaps. RECENT FINDINGS: Multiple challenges are faced in providing high-quality care to patients with psoriasis and psoriatic arthritis from the pre-diagnosis phase of disease to the follow-up period...
October 26, 2018: Current Rheumatology Reports
Dana DiRenzo, Monica Crespo-Bosque, Neda Gould, Patrick Finan, Julie Nanavati, Clifton O Bingham
PURPOSE OF REVIEW: To determine the efficacy of mindfulness-based interventions (MBIs) on clinical and patient-reported outcomes in rheumatoid arthritis (RA). RECENT FINDINGS: We identified randomized clinical trials from inception through April 2018 from MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, the Cochrane Library, and hand searches. After screening 338 references, we included five trials with one post-hoc analysis that evaluated MBIs and collectively included 399 participants...
October 18, 2018: Current Rheumatology Reports
Leon Lenchik, Ashley A Weaver, Robert J Ward, John M Boone, Robert D Boutin
PURPOSE OF REVIEW: Osteoporosis is disproportionately common in rheumatology patients. For the past three decades, the diagnosis of osteoporosis has benefited from well-established practice guidelines that emphasized the use of dual x-ray absorptiometry (DXA). Despite these guidelines and the wide availability of DXA, approximately two thirds of eligible patients do not undergo testing. One strategy to improve osteoporosis testing is to employ computed tomography (CT) examinations obtained as part of routine patient care to "opportunistically" screen for osteoporosis, without additional cost or radiation exposure to patients...
October 13, 2018: Current Rheumatology Reports
Christine A Pellegrini, Sara M Powell, Nicholas Mook, Katherine DeVivo, Linda Ehrlich-Jones
PURPOSE OF REVIEW: The purpose of this review paper is to provide an overview of the recent research using physical activity monitors in rheumatic populations including those with osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, and fibromyalgia. RECENT FINDINGS: Recent research demonstrates increased use of physical activity monitors in these populations, especially in those with osteoarthritis. Results from cross-sectional, longitudinal, and intervention studies highlight that physical activity levels are below recommended guidelines, yet evidence suggests benefits such as improving pain, fatigue, function, and overall well-being...
October 6, 2018: Current Rheumatology Reports
Yves Henrotin, Ali Mobasheri
PURPOSE OF REVIEW: Osteoarthritis, the most common joint disease, is associated with substantial medical costs, lost productivity, and reduced quality of life. However, available pharmaceutical treatments have limitations in terms of efficacy and long-term safety. RECENT FINDINGS: In vitro evidence suggests that some natural products may possess anti-inflammatory and anti-oxidative properties and may inhibit the release of key osteoarthritis-related cytokines. There is, therefore, ongoing interest in identifying natural products that safely promote joint health and treat osteoarthritis...
September 19, 2018: Current Rheumatology Reports
Laura J Tucker, Weiyu Ye, Laura C Coates
PURPOSE OF REVIEW: Psoriatic arthritis (PsA) is a chronic inflammatory spondyloarthritis that can cause progressive joint damage and irreversible disability. Advances in modern therapies, now mean a target of remission is an achievable goal in PsA. There is strong and consistent evidence that a treat-to-target (T2T) approach to PsA management results in better patient outcomes; however, the practicalities of incorporating this strategy into routine clinical practice remain a challenge...
September 18, 2018: Current Rheumatology Reports
Elizabeth Mabey, Andrew Rutherford, James Galloway
PURPOSE OF REVIEW: Fever is common within rheumatology but it is often challenging to identify its source. To do so correctly is paramount in patients with an underlying inflammatory condition receiving immunosuppressive therapy. This review article looks at the available evidence and merits of both 18F-fluoro-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans and new proposed biomarkers in determining the cause of fever within rheumatology. RECENT FINDINGS: 18F-FDG PET/CT scans are already an established tool in the detection and diagnosis of malignancy and are emerging for use in fever of unknown origin...
September 17, 2018: Current Rheumatology Reports
Ajay Premkumar, Kyle Morse, Ashley E Levack, Mathias P Bostrom, Alberto V Carli
PURPOSE OF REVIEW: Periprosthetic joint infection (PJI) is a devastating complication that can occur following total joint arthroplasty (TJA), causing significant morbidity and often requiring revision surgery. This goal of this manuscript is to review the current evidence for the prevention and diagnosis of PJI in patients with inflammatory arthritis. RECENT FINDINGS: Patients with inflammatory arthritis have a higher risk of PJI after TJA; however, there are several preventive, diagnostic, and therapeutic measures that can be optimized to lower the burden of PJI in this population...
September 10, 2018: Current Rheumatology Reports
Yu Zuo, Medha Barbhaiya, Doruk Erkan
PURPOSE OF REVIEW: To update our previous literature review and management recommendations on risk stratification and primary thrombosis prophylaxis in persistently antiphospholipid antibody (aPL)-positive individuals. RECENT FINDINGS: The estimated annual thrombosis incident rate (ATIR) among aPL-positive individuals with or without systemic autoimmune disease (SAIDx) is 0 to 5.3%, probably very low (<‚ÄČ1%/year) in those with no other SAIDx and thrombosis risk factors...
September 10, 2018: Current Rheumatology Reports
Sebastian Simon, Heinrich Resch, Klaus Klaushofer, Paul Roschger, Jochen Zwerina, Roland Kocijan
PURPOSE OF REVIEW: Hypophosphatasia (HPP) is a rare genetic disorder caused by mutations of the ALPL gene. ALPL encodes the tissue-non-specific isoenzyme of alkaline phosphatase (TNSALP). Consequently, bone mineralization is decreased leading to fractures, arthralgia, and extra-skeletal manifestations including tissue calcification, respiratory failure, and neurological complications. This review summarizes the most important clinical findings, diagnosis, and treatment options for HPP...
September 10, 2018: Current Rheumatology Reports
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