New insights into the pathogenesis and management of rheumatoid arthritis

Abstract

Over the past few decades, understanding of the pathogenesis of rheumatoid arthritis (RA) has improved substantially. Insights into the cellular and molecular mechanisms involved in RA have enabled the discovery of new therapeutic targets and led to the development of biologics and targeted synthetic disease‐modifying antirheumatic drugs. In parallel with the improvement in therapies, the evolution of strategies in the management of RA has also contributed considerably to better outcomes in patients. Major changes include the development of disease activity measures, formulation of the treat‐to‐target principles as well as increased attention to comorbidities. The presence of comorbidities such as cardiovascular diseases may increase the mortality of RA patients, affect their treatment strategies and result in worse outcomes. Therefore, prevention and management of certain high‐risk comorbidities have become increasingly important in the long‐term treatment of RA. In this study, we summarized new insights into the pathogenesis and management of rheumatoid arthritis and associated comorbidities, with a special focus on the 2021 update of the American College of Rheumatology (ACR) guideline for RA and key reports presented at the 2021 ACR convergence.

Xinfeng Capsule Inhibits Pyroptosis and Ameliorates Myocardial Injury in Rats with Adjuvant Arthritis via the GAS5/miR-21/TLR4 Axis

“… 30 RA patients are prevalently complicated by CVD, particularly cardiac lesions. 31 Therefore, it is of tremendous importance to search for new therapeutic approaches for preventing and controlling the progression of RA toward serious cardiovascular events. The present study explored the mechanism of XFC in treating RA myocardial injury through the establishment of an AA rat model to provide potential targets in improving the management of myocardial injury in RA.…”

Association between <i>COMMD1</i> gene polymorphism rs11125908 and rheumatoid arthritis in the Cuban population

“…It is characterized by inflammation in the synovial membrane, cartilage destruction, bone erosion, joint deformity, and functional disability in the affected patients (3). The goal of RA therapy is to obtain a prolonged state of health associated with improved quality of life by controlling symptoms, preventing structural damage to the joints, and normalizing the patient's physical condition (4). Genome-wide association studies (GWAS) have uncovered the highly polygenic etiology of RA.…”

Effects of bile salt-stimulated lipase on blood cells and associations with disease activity in human inflammatory joint disorders

“…However, previous studies showing that BSSL knockout mice are almost completely protected from developing collagen induced arthritis, and that anti-BSSL antibodies can be used to mitigate disease severity in mice and rat arthritis models [15] clearly supports the first alternative and thus point out BSSL as an exciting novel potential target for new anti-inflammatory drugs. Current therapies such as biologic disease-modifying anti-rheumatic drugs (bDMARDs) have contributed significantly to the improvement of reducing the disease activity and thus, to patients´quality of life, but they do have adverse effects [31,32]. Moreover, about one third of RA patients do not respond and 1/3 respond transiently, to these novel biological drugs [33,34] which further demonstrates the need for new complementary drugs with alternative targets.…”