PubMed Journal Database | Current rheumatology reports 
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Showing PubMed Articles 1–25 of 105 from Current rheumatology reports
Erratum to: Current Concept of Spondyloarthritis: Special Emphasis on Early Referral and Diagnosis.
Herbal Medicine for Rheumatic Diseases: Promises Kept?
Traditional healers throughout the world have relied on herbal medicines in their practices for millennia to treat a wide array of conditions, including arthritis. Present-day patients continue to seek care from complementary and alternative providers and more effective and less toxic treatments. A broad foundation of laboratory studies suggests that many herbal products have pertinent medicinal effects for the management of diseases like osteoarthritis and rheumatoid arthritis. However, few high quality cl...
Control of Arthritis Pain with Anti-Nerve-Growth Factor: Risk and Benefit.
Arthritis is characterized by pain and inflammation. Recently, attention has been focused on nerve-growth factor (NGF), a neurotrophin that is a key regulator of peripheral nociception because it mediates overexpression of proinflammatory neuron-derived molecules such as substance P, serotonin, and calcitonin gene-related peptide. Antibodies have been generated for NGF and its receptor that are effective in reducing pain in preclinical pain models, and clinical trials in patients with advanced knee and hip...
Pathogenesis of ANCA-Associated Vasculitis.
Antineutrophil cytoplasmic autoantibodies (ANCA)-associated vasculitides (AAV) are a group of systemic vasculitis syndromes characterized by inflammation and necrosis of blood vessel walls. Genetic, epigenetic, and environmental factors contribute to the etiology and pathogenesis of AAV. On the basis of currently available clinical and experimental evidence, it is reasonable to believe that, in predisposed patients, different triggers can lead to the production of autoantibodies (ANCA) that, in the context...
Juvenile Spondyloarthropathies.
Spondyloarthropathy (or spondyloarthritis) can begin in childhood (defined as individuals less than 16 years of age). These diseases are distinct in childhood, when compared with adult-onset disease. Because of overlapping features, especially sacroiliac joint involvement, diagnostic difficulty may arise from Behcet's disease, as well as familial Mediterranean fever. Despite advances in diagnostic techniques such as magnetic resonance imaging, the diagnosis of juvenile spondyloarthropathy may still be dela...
Advances in Therapy for ANCA-Associated Vasculitis.
The anti-neutrophil cytoplasmic antibody-associated vasculitides include granulomatosis with polyangiitis (Wegener's granulomatosis) and microscopic polyangiitis. The introduction of therapy with cytotoxic agents such as cyclophosphamide transformed these diseases from fatal diagnoses to chronic conditions characterized by cycles of relapse and remission. Modern treatment strategies have focused on minimizing cyclophosphamide exposure or eliminating its use altogether. Two randomized clinical trials have sh...
Treatment Strategies in Early Rheumatoid Arthritis and Prevention of Rheumatoid Arthritis.
Data now suggest that current strategies in the treatment of rheumatoid arthritis (RA) should focus on early identification and diagnosis, followed by early initiation of DMARD therapy. Initiation of treatment in early RA-ideally, less than 3-6 months after symptom onset-improves the success of achieving disease remission and reduces joint damage and disability. While the optimal treatment regimen in early RA is unclear, use of initial DMARD mono- or combination therapy with prompt escalation to achieve lo...
Uveitis in Seronegative Arthritis.
Uveitis is the most frequent extra-articular feature in seronegative arthritis and is part of the classification criteria for spondyloarthritis. Recent studies confirm a prevalence of up to one third of patients with spondyloarthritis and a relationship with HLA-B27 and disease duration. In recent forms of the disease, a relation with infectious episodes, inflammatory bowel disease, and cervical spine involvement has been reported. Many data argue for the implication of the IL23/IL17 pathway in uveitis, alr...
Belimumab and the Clinical Data.
Benlysta (belimumab) is a fully human recombinant monoclonal IgG antibody that neutralizes soluble B-lymphocyte stimulator and inhibits its biologic activity. Benlysta was recently approved by the US Food and Drug Administration to treat systemic lupus erythematosus (SLE). The current review discusses the data from the belimumab clinical trials and the role of this new medication in the treatment of SLE. We propose that Benlysta should be used in antinuclear antibody-positive patients with active disease in...
Altered Bone Biology in Psoriatic Arthritis.
Psoriatic arthritis (PsA) is characterized by focal bone erosions mediated by osteoclasts at the bone-pannus junction. The bulk of research over the past decade has centered on mechanisms that underlie osteoclastogenesis along with new insights into osteoimmunology; however, recent advances that focus on steps that lead to new bone formation are beginning to emerge. New revelations about bone formation may have direct relevance to PsA given the presence of enthesophytes, syndesmophytes, and bony ankylosis f...
Psoriatic arthritis is associated with a broad range of problems from the perspective of the patient. These include symptoms relating to skin and musculoskeletal disease to difficulties with day-to-day activities, social interactions, paid employment, and community participation. Additional problems related to frequent comorbidities impose further impact. It has been shown that individuals with psoriatic arthritis have similar or worse disability than men older than 75 years of age in the general populatio...
How Can Psoriatic Arthritis Be Diagnosed Early?
Psoriatic arthritis (PsA) is an inflammatory arthritis that usually develops after the onset of cutaneous psoriasis. Early diagnosis of PsA may lead to less joint damage and better long-term outcomes. Identifying inflammatory arthritis in individuals with psoriasis is the key to early diagnosis of PsA. Screening strategies targeted at individuals with psoriasis, as well as family members of patients with PsA will result in early identification of PsA. This article describes the various strategies that could...
For the first time in more than 50 years, the US Food and Drug Administration has approved a drug specifically for the treatment of systemic lupus erythematosus (SLE). This drug, belimumab, is a monoclonal antibody that neutralizes the B-cell survival factor, B-lymphocyte stimulator (BLyS). Although belimumab has demonstrated a very favorable safety profile, many SLE patients have failed to clinically improve from belimumab therapy. Three additional BLyS antagonists (atacicept, blisibimod, tabalumab) are c...
Belimumab Is Approved by the FDA: What More Do We Need to Know to Optimize Decision Making?
The March 2011 approval of belimumab (Benlysta) by the US Food and Drug Administration has left rheumatologists in a bit of a quandary regarding its use. It is officially intended for adult patients with autoantibody-positive systemic lupus erythematosus whose disease remains active despite receipt of standard-of-care therapy. The approved indication is broad and leaves interpretation to individual rheumatologists. Analyses of the phase 2 and 3 clinical trials of belimumab help answer some of the commonly a...
The Rationale for BAFF Inhibition in Systemic Lupus Erythematosus.
BAFF (B-cell-activating factor) is a critical survival factor for transitional and mature B cells and is a promising therapeutic target for systemic lupus erythematosus (SLE). In 2010-2011, two phase 3 clinical trials showed that the addition of the anti-BAFF antibody belimumab to standard-of-care therapy in patients with moderately active SLE results in a better outcome at 52 weeks than standard-of-care therapy alone. Belimumab has been US Food and Drug Administration approved for the treatment of SLE, an...
What Have Genome-Wide Studies Told Us About Psoriatic Arthritis?
There is convincing evidence to suggest a strong genetic component to psoriatic arthritis (PsA), with studies reporting a 40-fold risk to first-degree relatives of patients with disease. However, compared with rheumatoid arthritis, our understanding of the genetic etiology of PsA is less well-developed. Only three modestly sized genome-wide association studies of PsA have been undertaken to date, but they have identified the HLA-C region, IL12B, TRAF3IP2, and FBXL19 genes as being associated with PsA suscep...
Is Psoriatic Arthritis a Result of Abnormalities in Acquired or Innate Immunity?
Psoriatic arthritis is a common chronic inflammatory joint disease in which both inflammation and tissue damage contribute to the patient's outcome. Abnormal activation of the innate and the adaptive immune system contributes to the chronic disease process. Novel insights into these immune pathways are further corroborated by genetic evidence. In this review, we compare the current paradigm of psoriasis to mechanisms that likely play a role in psoriatic arthritis and provide an overview of the role of immun...
Understanding the factors associated with fracture is one of the main research objective of the osteoporosis epidemiology field. Tools such as FRAX have overall improved the ability of clinicians and researchers to identify individuals at high risk of fragility fractures. However, the performance of these tools in specific subpopulations needs further examination. We highlight recent studies that have shown under- or overestimation of fractures using FRAX in subpopulations, as well as recently proposed modi...
Endoplasmic Reticulum Stress in Skeletal Muscle Homeostasis and Disease.
Our appreciation of the role of endoplasmic reticulum (ER) stress pathways in both skeletal muscle homeostasis and the progression of muscle diseases is gaining momentum. This review provides insight into ER stress mechanisms during physiologic and pathological disturbances in skeletal muscle. The role of ER stress in the response to dietary alterations and acute stressors, including its role in autoimmune and genetic muscle disorders, has been described. Recent studies identifying ER stress markers in dise...
Morbidity and Mortality in Adult Polymyositis and Dermatomyositis.
Before the use of corticosteroids, the prognosis for polymyositis/dermatomyositis (PM/DM) was extremely poor. To date, although overall prognosis appears to be better, PM and DM are still considered to be associated with increased morbidity, primarily related to severe muscle weakness and visceral involvement. Recent series underline that only 20% to 40% of treated patients will achieve PM/DM remission, whereas 60% to 80% will experience a polycyclic or chronic, continuous course of the disease. PM/DM furth...
Gout is a common metabolic disorder resulting from supersaturation of uric acid in extracellular fluid and deposition of monosodium urate crystals in tissues. Gouty arthritis typically affects the peripheral joints of the appendicular skeleton, especially the feet and hands. Gouty involvement of the spine, however, is not as rare as generally perceived. Although it may be asymptomatic, tophaceous axial gout is also a well-documented cause of acute back pain, radiculopathy, and frank cord compression. As wit...
The Clinical Spectrum of Juvenile Idiopathic Arthritis in a Large Urban Population.
Urban populations present particular challenges for medical providers. Patients are extremely diverse, with varied socioeconomic, cultural, and ethnic backgrounds. Physicians caring for children with juvenile idiopathic arthritis must be prepared to interact effectively with many types of families who bring with them varied experiences and expectations. Pediatric rheumatologists should be familiar with patient characteristics that can influence disease outcomes. Access to care is affected by place of reside...
Gout and Organ Transplantation.
Acute and chronic gout are common complications following organ transplantation. Risk factors include those shared with the general population (eg, diuretic use) and transplant-specific risk factors (eg, cyclosporine). Clinical features of gout are similar to those seen in the general population, although tophi may be more common. A definitive diagnosis requires demonstration of monosodium urate crystals within synovial fluid or tophi. Treatment is often empiric, although a poor response should prompt joint...
What Do Cytokine Profiles Tell Us About Subsets of Juvenile Idiopathic Arthritis?
Classification of juvenile idiopathic arthritis is an ongoing process and up to now has been predominantly based on clinical manifestations-mainly number of joints at onset of disease. In the meantime, basic studies have advanced our knowledge regarding the disease pathogenesis. Unfortunately, studies of cytokines and cytokine polymorphisms have not followed the predominantly clinical International League of Associations for Rheumatology classification in that no significant biological differences among the...
The primary systemic vasculitides in childhood are quite rare except for Henoch-Schönlein purpura and Kawasaki disease. These are usually self-limited diseases. The etiopathogenesis for most of them is not clearly understood. However, it is usually thought that environmental triggers (mostly infectious) evoke an aggravated inflammatory response in susceptible individuals. The classification criteria for most of them were recently validated for children. Clinical manifestations are determined by the organs...
