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Rheumatoid Arthritis: HELP
Articles from Brigham and Women's Hospital
Based on 421 articles published since 2009
||||

These are the 421 published articles about Arthritis, Rheumatoid that originated from Brigham and Women's Hospital during 2009-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17
1 Guideline 2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty. 2017

Goodman, Susan M / Springer, Bryan / Guyatt, Gordon / Abdel, Matthew P / Dasa, Vinod / George, Michael / Gewurz-Singer, Ora / Giles, Jon T / Johnson, Beverly / Lee, Steve / Mandl, Lisa A / Mont, Michael A / Sculco, Peter / Sporer, Scott / Stryker, Louis / Turgunbaev, Marat / Brause, Barry / Chen, Antonia F / Gililland, Jeremy / Goodman, Mark / Hurley-Rosenblatt, Arlene / Kirou, Kyriakos / Losina, Elena / MacKenzie, Ronald / Michaud, Kaleb / Mikuls, Ted / Russell, Linda / Sah, Alexander / Miller, Amy S / Singh, Jasvinder A / Yates, Adolph. ·Susan M. Goodman, MD, Lisa A. Mandl, MD, MPH, Peter Sculco, MD, Barry Brause, MD, Kyriakos Kirou, MD, Ronald MacKenzie, MD, Linda Russell, MD: Hospital for Special Surgery/Weill Cornell Medicine, New York, New York. Electronic address: goodmans@hss.edu. · Bryan Springer, MD: OrthoCarolina Hip and Knee Center, Charlotte, North Carolina. · Gordon Guyatt, MD: McMaster University, Hamilton, Ontario, Canada. · Matthew P. Abdel, MD: Mayo Clinic, Rochester, Minnesota. · Vinod Dasa, MD: Louisiana State University, New Orleans. · Michael George, MD: University of Pennsylvania, Philadelphia. · Ora Gewurz-Singer, MD: University of Michigan, Ann Arbor. · Jon T. Giles, MD, MPH: Columbia University, New York, New York. · Beverly Johnson, MD: Albert Einstein College of Medicine, Bronx, New York. · Steve Lee, DO: Kaiser Permanente, Fontana, California. · Susan M. Goodman, MD, Lisa A. Mandl, MD, MPH, Peter Sculco, MD, Barry Brause, MD, Kyriakos Kirou, MD, Ronald MacKenzie, MD, Linda Russell, MD: Hospital for Special Surgery/Weill Cornell Medicine, New York, New York. · Michael A. Mont, MD: Cleveland Clinic, Cleveland, Ohio. · Scott Sporer, MD: Midwest Orthopaedics at Rush, Chicago, Illinois. · Louis Stryker, MD: University of Texas Medical Branch, Galveston. · Marat Turgunbaev, MD, MPH, Amy S. Miller: American College of Rheumatology, Atlanta, Georgia. · Antonia F. Chen, MD, MBA: Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. · Jeremy Gililland, MD: University of Utah, Salt Lake City. · Mark Goodman, MD, Adolph Yates, MD: University of Pittsburgh, Pittsburgh, Pennsylvania. · Arlene Hurley-Rosenblatt, ANP: Rockefeller University, New York, New York. · Elena Losina, PhD: Brigham and Women's Hospital, Boston, Massachusetts. · Kaleb Michaud, PhD: National Data Bank for Rheumatic Diseases, Wichita, Kansas and University of Nebraska Medical Center, Omaha. · Ted Mikuls, MD, MSPH: University of Nebraska Medical Center, Omaha. · Alexander Sah, MD: Dearborn-Sah Institute for Joint Restoration, Fremont, California. · Jasvinder A. Singh, MBBS, MPH: University of Alabama at Birmingham. ·J Arthroplasty · Pubmed #28629905.

ABSTRACT: OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA). METHODS: A panel of rheumatologists, orthopedic surgeons specializing in hip and knee arthroplasty, and methodologists was convened to construct the key clinical questions to be answered in the guideline. A multi-step systematic literature review was then conducted, from which evidence was synthesized for continuing versus withholding antirheumatic drug therapy and for optimal glucocorticoid management in the perioperative period. A Patient Panel was convened to determine patient values and preferences, and the Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence and the strength of recommendations, using a group consensus process through a convened Voting Panel of rheumatologists and orthopedic surgeons. The strength of the recommendation reflects the degree of certainty that benefits outweigh harms of the intervention, or vice versa, considering the quality of available evidence and the variability in patient values and preferences. RESULTS: The guideline addresses the perioperative use of antirheumatic drug therapy including traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib, and glucocorticoids in adults with RA, SpA, JIA, or SLE who are undergoing elective THA or TKA. It provides recommendations regarding when to continue, when to withhold, and when to restart these medications, and the optimal perioperative dosing of glucocorticoids. The guideline includes 7 recommendations, all of which are conditional and based on low- or moderate-quality evidence. CONCLUSION: This guideline should help decision-making by clinicians and patients regarding perioperative antirheumatic medication management at the time of elective THA or TKA. These conditional recommendations reflect the paucity of high-quality direct randomized controlled trial data.

2 Guideline 2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty. 2017

Goodman, Susan M / Springer, Bryan / Guyatt, Gordon / Abdel, Matthew P / Dasa, Vinod / George, Michael / Gewurz-Singer, Ora / Giles, Jon T / Johnson, Beverly / Lee, Steve / Mandl, Lisa A / Mont, Michael A / Sculco, Peter / Sporer, Scott / Stryker, Louis / Turgunbaev, Marat / Brause, Barry / Chen, Antonia F / Gililland, Jeremy / Goodman, Mark / Hurley-Rosenblatt, Arlene / Kirou, Kyriakos / Losina, Elena / MacKenzie, Ronald / Michaud, Kaleb / Mikuls, Ted / Russell, Linda / Sah, Alexander / Miller, Amy S / Singh, Jasvinder A / Yates, Adolph. ·Hospital for Special Surgery/Weill Cornell Medicine, New York, New York. · OrthoCarolina Hip and Knee Center, Charlotte, North Carolina. · McMaster University, Hamilton, Ontario, Canada. · Mayo Clinic, Rochester, Minnesota. · Louisiana State University, New Orleans. · University of Pennsylvania, Philadelphia. · University of Michigan, Ann Arbor. · Columbia University, New York, New York. · Albert Einstein College of Medicine, Bronx, New York. · Kaiser Permanente, Fontana, California. · Cleveland Clinic, Cleveland, Ohio. · Midwest Orthopaedics at Rush, Chicago, Illinois. · University of Texas Medical Branch, Galveston. · American College of Rheumatology, Atlanta, Georgia. · Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. · University of Utah, Salt Lake City. · University of Pittsburgh, Pittsburgh, Pennsylvania. · Rockefeller University, New York, New York. · Brigham and Women's Hospital, Boston, Massachusetts. · National Data Bank for Rheumatic Diseases, Wichita, Kansas, and University of Nebraska Medical Center, Omaha. · University of Nebraska Medical Center, Omaha. · Dearborn-Sah Institute for Joint Restoration, Fremont, California. · University of Alabama at Birmingham. ·Arthritis Rheumatol · Pubmed #28620948.

ABSTRACT: OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA). METHODS: A panel of rheumatologists, orthopedic surgeons specializing in hip and knee arthroplasty, and methodologists was convened to construct the key clinical questions to be answered in the guideline. A multi-step systematic literature review was then conducted, from which evidence was synthesized for continuing versus withholding antirheumatic drug therapy and for optimal glucocorticoid management in the perioperative period. A Patient Panel was convened to determine patient values and preferences, and the Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence and the strength of recommendations, using a group consensus process through a convened Voting Panel of rheumatologists and orthopedic surgeons. The strength of the recommendation reflects the degree of certainty that benefits outweigh harms of the intervention, or vice versa, considering the quality of available evidence and the variability in patient values and preferences. RESULTS: The guideline addresses the perioperative use of antirheumatic drug therapy including traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib, and glucocorticoids in adults with RA, SpA, JIA, or SLE who are undergoing elective THA or TKA. It provides recommendations regarding when to continue, when to withhold, and when to restart these medications, and the optimal perioperative dosing of glucocorticoids. The guideline includes 7 recommendations, all of which are conditional and based on low- or moderate-quality evidence. CONCLUSION: This guideline should help decision-making by clinicians and patients regarding perioperative antirheumatic medication management at the time of elective THA or TKA. These conditional recommendations reflect the paucity of high-quality direct randomized controlled trial data.

3 Editorial Editorial: Lymphocyte Highs and Lows With Baricitinib. 2018

Rao, Deepak A. ·Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. ·Arthritis Rheumatol · Pubmed #30058141.

ABSTRACT: -- No abstract --

4 Editorial Methotrexate: who would have predicted its importance in rheumatoid arthritis? 2018

Weinblatt, Michael E. ·Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. mweinblatt@partners.org. ·Arthritis Res Ther · Pubmed #29848356.

ABSTRACT: -- No abstract --

5 Editorial Improvement at Any Cost? The Art and Science of Choosing Treatment Strategies for Rheumatoid Arthritis. 2017

Losina, Elena / Katz, Jeffrey N. ·From Brigham and Women's Hospital, Boston, Massachusetts. ·Ann Intern Med · Pubmed #28554193.

ABSTRACT: -- No abstract --

6 Editorial Editorial: inflammation, disease-modifying antirheumatic drugs, lipids, and cardiovascular risk in rheumatoid arthritis. 2015

Liao, Katherine P / Solomon, Daniel H. ·Brigham and Women's Hospital, Boston, Massachusetts. ·Arthritis Rheumatol · Pubmed #25331004.

ABSTRACT: -- No abstract --

7 Editorial Mechanistic insights into the link between inflammation and cardiovascular disease: rheumatoid arthritis as a human model of inflammation. 2014

Liao, Katherine P / Solomon, Daniel H. ·From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA. kliao@partners.org. · From the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA. ·Circ Cardiovasc Imaging · Pubmed #25027451.

ABSTRACT: -- No abstract --

8 Editorial Swollen to tender joint count ratio: a novel combination of routine measures to assess pain and treatment response in rheumatoid arthritis. 2014

Lee, Yvonne C. ·Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts. ·Arthritis Care Res (Hoboken) · Pubmed #23982975.

ABSTRACT: -- No abstract --

9 Review Rheumatoid Arthritis. 2019

Sparks, Jeffrey A. ·From Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. (J.A.S.). ·Ann Intern Med · Pubmed #30596879.

ABSTRACT: Rheumatoid arthritis (RA) is a common systemic inflammatory autoimmune disease characterized by painful, swollen joints that can severely impair physical function and quality of life. The presenting symptoms of musculoskeletal pain, swelling, and stiffness are common in clinical practice, so familiarity with diagnosing and managing RA is crucial. Patients with RA are at greater risk for serious infection, respiratory disease, osteoporosis, cardiovascular disease, cancer, and mortality than the general population. In recent years, early diagnosis, aggressive treatment, and expanded therapeutic options of disease-modifying antirheumatic drugs have markedly improved both the management and long-term prognosis of RA.

10 Review T Cells That Help B Cells in Chronically Inflamed Tissues. 2018

Rao, Deepak A. ·Division of Rheumatology, Immunology, Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. ·Front Immunol · Pubmed #30190721.

ABSTRACT: Chronically inflamed tissues commonly accrue lymphocyte aggregates that facilitate local T cell-B cell interactions. These aggregates can range from small, loosely arranged lymphocyte clusters to large, organized ectopic lymphoid structures. In some cases, ectopic lymphoid structures develop germinal centers that house prototypical T follicular helper (Tfh) cells with high expression of Bcl6, CXCR5, PD-1, and ICOS. However, in many chronically inflamed tissues, the T cells that interact with B cells show substantial differences from Tfh cells in their surface phenotypes, migratory capacity, and transcriptional regulation. This review discusses observations from multiple diseases and models in which tissue-infiltrating T cells produce factors associated with B cell help, including IL-21 and the B cell chemoattractant CXCL13, yet vary dramatically in their resemblance to Tfh cells. Particular attention is given to the PD-1

11 Review Inflammatory arthritis and crystal arthropathy: Current concepts of skin and systemic manifestations. 2018

Fazel, Mahdieh / Merola, Joseph F / Kurtzman, Drew J B. ·Division of Dermatology, The University of Arizona College of Medicine, Tucson, Arizona, USA. · Division of Rheumatology and Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. · Division of Dermatology, The University of Arizona College of Medicine, Tucson, Arizona, USA. Electronic address: kurtzman@email.arizona.edu. ·Clin Dermatol · Pubmed #30047436.

ABSTRACT: Systemic inflammatory disorders frequently involve the skin, and when cutaneous disease develops, such dermatologic manifestations may represent the initial sign of disease and may also provide valuable prognostic information about the underlying disorder. Familiarity with the various skin manifestations of systemic disease is therefore paramount and increases the likelihood of accurate diagnosis, which may facilitate the implementation of an appropriate treatment strategy. An improvement in quality of life and a reduction in the degree of morbidity may also be a realized benefit of accurate recognition of these skin signs. With this context in mind, this review highlights the salient clinical features and unique dermatologic manifestations of rheumatoid arthritis, adult-onset Still's disease, and the crystal arthropathy, gout.

12 Review Cardiovascular Safety of Biologics and JAK Inhibitors in Patients with Rheumatoid Arthritis. 2018

Kang, Eun Ha / Liao, Katherine P / Kim, Seoyoung C. ·Division of Rheumatology Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea. · Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. · Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. sykim@bwh.harvard.edu. · Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA. sykim@bwh.harvard.edu. ·Curr Rheumatol Rep · Pubmed #29846814.

ABSTRACT: PURPOSE OF REVIEW: Increased cardiovascular (CV) risk and associated mortality in rheumatoid arthritis (RA) are not fully explained by traditional CV risk factors. This review discusses the epidemiology and mechanisms of increased CV risk in RA and treatment effects on CV risk focusing on biologic disease-modifying anti-rheumatic drugs (DMARDs) and JAK inhibitors. RECENT FINDINGS: Intermediary metabolic changes by inflammatory cytokines are observed in body composition, lipid profile, and insulin sensitivity of RA patients, leading to accelerated atherosclerosis and increased CV risk. Successful treatment with DMARDs has shown beneficial effects on these metabolic changes and ultimately CV outcomes, in proportion to the treatment efficacy in general but also with drug-specific mechanisms. Recent data provide further information on comparative CV safety between biologic DMARDs or JAK inhibitors as well as their safety signals for non-atherosclerotic CV events. CV benefits or safety signals associated with DMARD treatments can differ despite similar drug efficacy against RA, suggesting that both anti-inflammatory and drug-specific mechanisms are involved in altering CV risk.

13 Review Primary myelofibrosis but not autoimmune myelofibrosis accompanied by Sjögren's syndrome and primary biliary cirrhosis in a patient with trisomy 8 mosaic: a case report and literature review. 2018

Lu, Chenyang / Wu, Xiaoyan / Wen, Hongyan / Gao, Huiying / Wang, Caihong / Yang, Bo / Liang, Zhipeng / Gao, Chong / Li, Xiaofeng. ·Department of Rheumatology and Immunology, The Second Hospital of Shanxi Medical University, Taiyuan, China. · Department of Haematology, The Second Hospital of Shanxi Medical University, Taiyuan, China. · Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA. · Department of Rheumatology and Immunology, The Second Hospital of Shanxi Medical University, Taiyuan, China. 13753139859@163.com. ·Clin Exp Rheumatol · Pubmed #29745886.

ABSTRACT: Bone marrow fibrosis has been found to be associated with autoimmune disorders, and autoimmune myelofibrosis (AIMF) has been defined. Primary myelofibrosis (PMF), a clonal myeloproliferative disorder, should be distinguished from AIMF which has a good response to steroids, as the former has a high mortality and very bad response to conventional treatment. This case report describes a rare case of PMF accompanied with Sjögren's syndrome (SJS) and primary biliary cirrhosis (PBC), in a patient with trisomy 8 mosaic. Careful clinical assessment, gene mutation screening, and bone marrow evaluation can lead to an accurate diagnosis.

14 Review Lipids in RA: Is Less Not Necessarily More? 2018

Plutzky, Jorge / Liao, Katherine P. ·Division of Cardiology, Brigham and Women's Hospital, Boston, MA, USA. · Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA, 02115, USA. kliao@bwh.harvard.edu. ·Curr Rheumatol Rep · Pubmed #29464513.

ABSTRACT: PURPOSE OF REVIEW: In rheumatoid arthritis (RA), lipid levels are dynamic and can fluctuate along with changes in inflammation. A reduction in inflammation, most commonly as a result of disease-modifying anti-rheumatic drug (DMARD) therapy, is associated with increases in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). In this review, we discuss new evidence shedding light on the potential mechanism underlying changes in lipid levels observed with changes in inflammation. RECENT FINDINGS: Measured lipid levels in the blood are a result of a balance between synthesis and catabolism or absorption. Recent human studies in active RA show that the catabolic rates of lipids are higher than expected compared to expected rates in the general population. DMARD therapy appears to allow a return to baseline lower catabolic rates, resulting in an apparent increase in lipids. Increases in lipids observed with control of inflammation and RA treatment suggest a return to homeostasis. Studies are underway to understand the overall impact on cardiovascular risk in RA when lipid levels increase as a result of controlling inflammation.

15 Review Rheumatoid arthritis. 2018

Smolen, Josef S / Aletaha, Daniel / Barton, Anne / Burmester, Gerd R / Emery, Paul / Firestein, Gary S / Kavanaugh, Arthur / McInnes, Iain B / Solomon, Daniel H / Strand, Vibeke / Yamamoto, Kazuhiko. ·Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. · Arthritis Research UK Centre for Genetics and Genomics and NIHR Manchester Biomedical Research Centre, Manchester Academic Health Sciences Centre, The University of Manchester and Central Manchester Foundation Trust, Manchester, UK. · Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapel Allerton Hospital, Leeds, UK. · NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK. · Division of Rheumatology, Allergy and Immunology, University of California-San Diego School of Medicine, La Jolla, CA, USA. · Institute of Infection Immunity and Inflammation, University of Glasgow, Glasgow, UK. · Division of Rheumatology, Brigham and Women's Hospital, Boston, MA, USA. · Division of Immunology and Rheumatology, Stanford University, Palo Alto, CA, USA. · Laboratory for Autoimmune Diseases, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan. ·Nat Rev Dis Primers · Pubmed #29417936.

ABSTRACT: Rheumatoid arthritis (RA) is a chronic, inflammatory, autoimmune disease that primarily affects the joints and is associated with autoantibodies that target various molecules including modified self-epitopes. The identification of novel autoantibodies has improved diagnostic accuracy, and newly developed classification criteria facilitate the recognition and study of the disease early in its course. New clinical assessment tools are able to better characterize disease activity states, which are correlated with progression of damage and disability, and permit improved follow-up. In addition, better understanding of the pathogenesis of RA through recognition of key cells and cytokines has led to the development of targeted disease-modifying antirheumatic drugs. Altogether, the improved understanding of the pathogenetic processes involved, rational use of established drugs and development of new drugs and reliable assessment tools have drastically altered the lives of individuals with RA over the past 2 decades. Current strategies strive for early referral, early diagnosis and early start of effective therapy aimed at remission or, at the least, low disease activity, with rapid adaptation of treatment if this target is not reached. This treat-to-target approach prevents progression of joint damage and optimizes physical functioning, work and social participation. In this Primer, we discuss the epidemiology, pathophysiology, diagnosis and management of RA.

16 Review Rheumatoid arthritis in 2017: Protective dietary and hormonal factors brought to light. 2018

Sparks, Jeffrey A / Costenbader, Karen H. ·Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, 60 Fenwood Road, Boston, Massachusetts 02115, USA. ·Nat Rev Rheumatol · Pubmed #29323341.

ABSTRACT: -- No abstract --

17 Review Functional genomics of stromal cells in chronic inflammatory diseases. 2018

Slowikowski, Kamil / Wei, Kevin / Brenner, Michael B / Raychaudhuri, Soumya. ·Center for Data Sciences, Brigham and Women's Hospital. · Division of Genetics, Brigham and Women's Hospital and Harvard Medical School, Boston. · Program in Medical and Population Genetics, Broad Institute of Massachusetts Technical Institute and Harvard University, Cambridge. · Department of Biomedical Informatics, Harvard Medical School. · Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. · Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom. ·Curr Opin Rheumatol · Pubmed #28984647.

ABSTRACT: PURPOSE OF REVIEW: Stroma is a broad term referring to the connective tissue matrix in which other cells reside. It is composed of diverse cell types with functions such as extracellular matrix maintenance, blood and lymph vessel development, and effector cell recruitment. The tissue microenvironment is determined by the molecular characteristics and relative abundances of different stromal cells such as fibroblasts, endothelial cells, pericytes, and mesenchymal precursor cells. Stromal cell heterogeneity is explained by embryonic developmental lineage, stages of differentiation to other cell types, and activation states. Interaction between immune and stromal cell types is critical to wound healing, cancer, and a wide range of inflammatory diseases. Here, we review recent studies of inflammatory diseases that use functional genomics and single-cell technologies to identify and characterize stromal cell types associated with pathogenesis. RECENT FINDINGS: High dimensional strategies using mRNA sequencing, mass cytometry, and fluorescence activated cell-sorting with fresh primary tissue samples are producing detailed views of what is happening in diseased tissue in rheumatoid arthritis, inflammatory bowel disease, and cancer. Fibroblasts positive for CD90 (Thy-1) are enriched in the synovium of rheumatoid arthritis patients. Single-cell RNA-seq studies will lead to more discoveries about the stroma in the near future. SUMMARY: Stromal cells form the microenvironment of inflamed and diseased tissues. Functional genomics is producing an increasingly detailed view of subsets of stromal cells with pathogenic functions in rheumatic diseases and cancer. Future genomics studies will discover disease mechanisms by perturbing molecular pathways with chemokines and therapies known to affect patient outcomes. Functional genomics studies with large sample sizes of patient tissues will identify patient subsets with different disease phenotypes or treatment responses.

18 Review Leveraging blood and tissue CD4+ T cell heterogeneity at the single cell level to identify mechanisms of disease in rheumatoid arthritis. 2017

Fonseka, Chamith Y / Rao, Deepak A / Raychaudhuri, Soumya. ·Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA; Division of Genetics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA; Program in Medical and Population Genetics, Broad Institute of Massachusetts Technical Institute and Harvard University, Cambridge, MA 02138, USA; Center for Data Sciences, Brigham and Women's Hospital, Boston, MA 02115, USA; Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA. · Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. · Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA; Division of Genetics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA; Program in Medical and Population Genetics, Broad Institute of Massachusetts Technical Institute and Harvard University, Cambridge, MA 02138, USA; Center for Data Sciences, Brigham and Women's Hospital, Boston, MA 02115, USA; Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA; Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. Electronic address: soumya@broadinstitute.org. ·Curr Opin Immunol · Pubmed #28888129.

ABSTRACT: CD4+ T cells have been long known to play an important role in the pathogenesis of rheumatoid arthritis (RA), but the specific cell populations and states that drive the disease have been challenging to identify with low dimensional single cell data and bulk assays. The advent of high dimensional single cell technologies-like single cell RNA-seq or mass cytometry-has offered promise to defining key populations, but brings new methodological and statistical challenges. Recent single cell profiling studies have revealed a broad diversity of cell types among CD4+ T cells, identifying novel populations that are expanded or altered in RA. Here, we will review recent findings on CD4+ T cell heterogeneity and RA that have come from single cell profiling studies and discuss the best practices for conducting these studies.

19 Review Genomic Influences on Susceptibility and Severity of Rheumatoid Arthritis. 2017

Knevel, Rachel / Huizinga, Tom W J / Kurreeman, Fina. ·Brigham and Women's Hospital, Division of Genetics, Raychaudhuri Lab, 77 Avenue Louis Pasteur, 2th Floor, Room 255, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands; The Broad Institute, 415 Main Street, Cambridge, MA 02142, USA. Electronic address: rknevel@bwh.harvard.edu. · Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. ·Rheum Dis Clin North Am · Pubmed #28711138.

ABSTRACT: Genetics in rheumatoid arthritis (RA) has moved from the finding of HLA-shared epitope decades ago toward the understanding of the role of HLA in RA and the findings of ∼100 additional genetic risk variants for disease susceptibility as well as several risk variants for severe disease. These findings increased our understanding of RA abnormality. Still, the mechanisms by which many of the variants exhibit their effect are not yet understood.

20 Review 2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty. 2017

Goodman, Susan M / Springer, Bryan / Guyatt, Gordon / Abdel, Matthew P / Dasa, Vinod / George, Michael / Gewurz-Singer, Ora / Giles, Jon T / Johnson, Beverly / Lee, Steve / Mandl, Lisa A / Mont, Michael A / Sculco, Peter / Sporer, Scott / Stryker, Louis / Turgunbaev, Marat / Brause, Barry / Chen, Antonia F / Gililland, Jeremy / Goodman, Mark / Hurley-Rosenblatt, Arlene / Kirou, Kyriakos / Losina, Elena / MacKenzie, Ronald / Michaud, Kaleb / Mikuls, Ted / Russell, Linda / Sah, Alexander / Miller, Amy S / Singh, Jasvinder A / Yates, Adolph. ·Hospital for Special Surgery/Weill Cornell Medicine, New York, New York. · OrthoCarolina Hip and Knee Center, Charlotte, North Carolina. · McMaster University, Hamilton, Ontario, Canada. · Mayo Clinic, Rochester, Minnesota. · Louisiana State University, New Orleans. · University of Pennsylvania, Philadelphia. · University of Michigan, Ann Arbor. · Columbia University, New York, New York. · Albert Einstein College of Medicine, Bronx, New York. · Kaiser Permanente, Fontana, California. · Cleveland Clinic, Cleveland, Ohio. · Midwest Orthopaedics at Rush, Chicago, Illinois. · University of Texas Medical Branch, Galveston. · American College of Rheumatology, Atlanta, Georgia. · Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. · University of Utah, Salt Lake City. · University of Pittsburgh, Pittsburgh, Pennsylvania. · Rockefeller University, New York, New York. · Brigham and Women's Hospital, Boston, Massachusetts. · National Data Bank for Rheumatic Diseases, Wichita, Kansas and University of Nebraska Medical Center, Omaha. · University of Nebraska Medical Center, Omaha. · Dearborn-Sah Institute for Joint Restoration, Fremont, California. · University of Alabama at Birmingham. ·Arthritis Care Res (Hoboken) · Pubmed #28620917.

ABSTRACT: OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA). METHODS: A panel of rheumatologists, orthopedic surgeons specializing in hip and knee arthroplasty, and methodologists was convened to construct the key clinical questions to be answered in the guideline. A multi-step systematic literature review was then conducted, from which evidence was synthesized for continuing versus withholding antirheumatic drug therapy and for optimal glucocorticoid management in the perioperative period. A Patient Panel was convened to determine patient values and preferences, and the Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence and the strength of recommendations, using a group consensus process through a convened Voting Panel of rheumatologists and orthopedic surgeons. The strength of the recommendation reflects the degree of certainty that benefits outweigh harms of the intervention, or vice versa, considering the quality of available evidence and the variability in patient values and preferences. RESULTS: The guideline addresses the perioperative use of antirheumatic drug therapy including traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib, and glucocorticoids in adults with RA, SpA, JIA, or SLE who are undergoing elective THA or TKA. It provides recommendations regarding when to continue, when to withhold, and when to restart these medications, and the optimal perioperative dosing of glucocorticoids. The guideline includes 7 recommendations, all of which are conditional and based on low- or moderate-quality evidence. CONCLUSION: This guideline should help decision-making by clinicians and patients regarding perioperative antirheumatic medication management at the time of elective THA or TKA. These conditional recommendations reflect the paucity of high-quality direct randomized controlled trial data.

21 Review Lactation and Management of Postpartum Disease. 2017

Bermas, Bonnie L. ·Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, BTM 60 Fenwood Road, Boston, MA 02115, USA. Electronic address: bbermas@partners.org. ·Rheum Dis Clin North Am · Pubmed #28390567.

ABSTRACT: While much of the existing literature in the field of reproductive rheumatology focuses on fertility, preconception counseling, and pregnancy, there is limited information regarding the postpartum period and lactation. Evidence suggests that many rheumatologic disorders flare after delivery, which, along with limitations in medications compatible with breastfeeding, make this time period challenging for women with rheumatologic conditions. This article discusses rheumatologic disease activity during the postpartum period and reviews the safety during lactation of commonly used medications for the management of rheumatic diseases. Fortunately, many of the commonly used medications are compatible with breastfeeding.

22 Review Cardiovascular disease in patients with rheumatoid arthritis. 2017

Liao, Katherine P. ·Division of Rheumatology, Immunology, and Allergy, Brigham and Women׳s Hospital, 75 Francis St, PBB-B3, Boston, MA 02115. Electronic address: kliao@partners.org. ·Trends Cardiovasc Med · Pubmed #27612551.

ABSTRACT: The risk of cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA) is 1.5-2-fold higher than age- and sex-matched individuals from the general population. This excess risk is attributed to the systemic chronic inflammation which is a hallmark of RA. Challenges to optimizing CV risk management in RA include the need for improved methods to predict CV risk, and defining the target risk factor(s) to reduce CV risk. Lessons learned from RA studies can also inform CV risk prevention in the general population, where inflammation also has an important role in the pathogenesis of atherosclerosis.

23 Review Bioequivalence of Biosimilar Tumor Necrosis Factor-α Inhibitors Compared With Their Reference Biologics: A Systematic Review. 2016

Chingcuanco, Francine / Segal, Jodi B / Kim, Seoyoung C / Alexander, G Caleb. ·From Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and Brigham and Women's Hospital, Boston, Massachusetts. ·Ann Intern Med · Pubmed #27479870.

ABSTRACT: Background: Biosimilars are of growing clinical, regulatory, and commercial importance. Purpose: To summarize evidence about the bioequivalence between biosimilar and reference tumor necrosis factor-α (TNF-α) inhibitors. Data Sources: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and LILACS from inception through 13 April 2016 and ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, EU Clinical Trials Register, U.S. Food and Drug Administration, and European Medicines Agency from inception through 30 April 2016. Study Selection: Published English-language studies of any size or design that compared the pharmacokinetics, clinical efficacy, adverse events, or immunogenicity of a biosimilar TNF-α inhibitor with a reference biologic in humans. Data Extraction: Two reviewers independently screened titles and abstracts, extracted data from selected studies, and assessed study quality. Data Synthesis: Of 19 eligible studies, 8 were phase 1 randomized trials, 5 were phase 3 randomized trials, and 6 were observational studies. Most phase 1 trials (n = 7) involved healthy volunteers, phase 3 trials involved patients with rheumatoid arthritis, and observational studies involved those with rheumatoid arthritis or inflammatory bowel disease. All phase 1 trials showed that pharmacokinetic parameters of the biosimilar and respective biologic were within the prespecified equivalence margin of 80% to 125%. Phase 3 trials suggested similar clinical responses and adverse events. Adverse events were usually of mild to moderate severity. Two cross-sectional observational studies showed cross-reactivity between products, whereas 4 cohort studies of patients switched from reference to biosimilar products suggested similar efficacy and safety outcomes. Limitation: Possible publication bias, small sample sizes of many studies, and lack of published studies for several biosimilars. Conclusion: Preliminary evidence supports the biosimilarity and interchangeability of biosimilar and reference TNF-α inhibitors. Primary Funding Source: Johns Hopkins Center of Excellence in Regulatory Science and Innovation. (PROSPERO: CRD42015025262).

24 Review Preventive Treatments for Rheumatoid Arthritis: Issues Regarding Patient Preferences. 2016

Finckh, Axel / Escher, Monica / Liang, Matthew H / Bansback, Nick. ·Division of Rheumatology, University Hospitals of Geneva (HUG), 26, Av. Beau-Séjour, CH-1211, Geneva 14, Switzerland. axel.finckh@hcuge.ch. · Pain and Palliative Care Consultation, Division of Clinical Pharmacology and Toxicology, University Hospitals of Geneva, Geneva, Switzerland. · Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA. · Section of Rheumatology, VA Boston Healthcare System, Boston, MA, USA. · School of Population and Public Health, University of British Columbia, Vancouver, Canada. ·Curr Rheumatol Rep · Pubmed #27402108.

ABSTRACT: The detection of biomarkers in the preclinical phase of rheumatoid arthritis (RA) and recent therapeutic advances suggest that it may be possible to identify and treat persons at high risk and to prevent the development of RA. Several trials are ongoing to test the efficacy of a therapeutic intervention in primary prevention. This paper reviews potential populations that might be considered for preventative medication. Further, we review the medications that are being explored to treat individuals considered at high risk of developing RA. Finally, in a group of asymptomatic individuals at high risk of developing RA, we assessed which factors mattered most when considering a preventive therapeutic intervention and what type of preventive treatment would be most acceptable to them. Understanding subjects' perceptions of risks and benefits and willingness to undergo preventive therapy will be important in designing and implementing screening and preventive strategies.

25 Review Recent Advances in Defining the Genetic Basis of Rheumatoid Arthritis. 2016

Terao, Chikashi / Raychaudhuri, Soumya / Gregersen, Peter K. ·Divisions of Genetics and Rheumatology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115. · Partners Center for Personalized Genetic Medicine, Boston, Massachusetts 02115. · Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142; email: soumya@broadinstitute.org. · Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto 606-8501, Japan; email: a0001101@kuhp.kyoto-u.ac.jp. · Institute of Inflammation and Repair, University of Manchester, M15 6SZ Manchester, United Kingdom. · Rheumatology Unit, Department of Medicine, Karolinska Institutet and Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden. · Robert S. Boas Center for Genomics and Human Genetics, The Feinstein Institute for Medical Research, Manhasset, New York 11030; email: peterg@nshs.edu. ·Annu Rev Genomics Hum Genet · Pubmed #27216775.

ABSTRACT: Rheumatoid arthritis (RA) is the most common inflammatory arthritis and exhibits genetic overlap with other autoimmune and inflammatory disorders. Although predominant associations with the HLA-DRB1 locus have been known for decades, recent data have revealed additional insight into the likely causative variants within HLA-DRB1 as well as within other HLA loci that contribute to disease risk. In addition, more than 100 common variants in non-HLA loci have been implicated in disease susceptibility. Genetic factors are involved not only in the development of RA, but also with various disease subphenotypes, including production and circulating levels of autoantibodies and joint destruction. The major current challenge is to integrate these new data into a precise understanding of disease pathogenesis, including the critical cell types and molecular networks involved as well as interactions with environmental factors. We predict that delineating the functional effects of genetic variants is likely to drive new diagnostic and therapeutic approaches to the disease.

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