Two complimentary studies provide a deeper understanding of Lyme disease and the associated chronic complications, such as Lyme arthritis.

The increased incidence of deep vein thromboses and pulmonary emboli has long been noted in rheumatoid arthritis and has been ascribed to the effects of chronic inflammation and disease activity, as well as to specific biologic DMARDs and JAK inhibitors. Reporting in ACR Open Rheumatology, Zavoriti and Miossec provide data that might explain the prothrombotic effects of the JAK inhibitor tofacitinib

Separate guidelines are needed for the management and diagnosis of rheumatic diseases in low- and middle-income countries, especially with the advent of expensive biological therapies and monitoring techniques. The lack of robust data on the efficacy of low-cost drugs and biosimilars in these countries limits the development of data-driven guidelines.

Findings implicate anti-PAD4 antibodies in the pathogenesis of rheumatoid arthritis.

Withdrawing immunosuppressive treatment in systemic lupus erythematosus offers reduced toxicity and improved quality of life for patients in remission but carries a risk of disease reactivation. Emerging studies emphasize the importance of identifying patients who can safely discontinue therapy using clinical criteria and molecular profiling to guide personalized strategies.

Urate crystals alone are required but not sufficient to trigger gout flares; they can also be modulated by environmental, metabolic, genetic and epigenetic factors. Avoiding large variation in urate levels, maintaining prophylaxis until crystal clearance and initiating low-dose urate-lowering therapy are efficient strategies for disease management.

Activation of N-acetylgalactosaminyltransferases in synovial fibroblasts promotes the degradation of the extracellular matrix in arthritis.

Calcium pyrophosphate deposition (CPPD) disease is secondary to the pathological accumulation of calcium pyrophosphate (CPP) crystals inside joints and involves acute or chronic inflammatory arthritis. Epidemiological research on CPPD has been slow despite the suspected high prevalence of this condition. Here we highlight key challenges in CPPD imaging, diagnosis and nomenclature that need to be addressed

Altered metabolism of the tricarboxylic acid cycle metabolite fumarate drives activation of interferon release in systemic sclerosis monocytes, suggesting a potential therapeutic approach.

In the phase III SELECT-GCA trial, upadacitinib at a dose of 15 mg daily was superior to placebo with respect to achievement of sustained remission of giant cell arteritis at 52 weeks.

Lipid nanoparticle carriers of immunosuppressive mRNA shape tolerogenic antigen-presenting cells that inhibit arthritis progression in mice.

Although autoimmune rheumatic diseases are more prevalent in women than men, few clinical trials report findings on the basis of sex and gender. Future clinical trials should report sex and gender differences in treatment and safety outcomes in a standardized manner to improve outcomes for all patients.

Findings indicate that women and men with rheumatoid arthritis have different treatment responses to anti-TNF therapy.

A study provides insights into the role of CXCL7 in bone erosion in rheumatoid arthritis.

TGFβ compromises T cell responses against Epstein–Barr virus (EBV) and is associated with EBV reactivation in children with multisystem inflammatory syndrome (MIS-C).

Ultraviolet light-induced mitochondrial damage in keratinocytes leads to accumulation of Z-DNA, perpetuating type I interferon responses in cutaneous lupus.

Analysis of synovial tissue samples led to the identification of inflammatory and fibrotic subgroups of osteoarthritis, which were associated with distinct fibroblast and macrophage populations.

Molecular imaging techniques such as PET with the leukocyte-targeted probe 89Zr-CD45 are promising tools for rheumatology, providing a non-invasive whole-body assessment of the mechanisms that drive tissue inflammation. These techniques could improve diagnosis and disease monitoring, but further research is required before clinical implementation.

Cumulative exposure to oestrogens over a woman’s lifetime is associated with the risk of developing seronegative inflammatory arthritis.

Gluconolactone promotes Treg cell function and might have potential for treating skin lesions in systemic lupus erythematosus.

Treating people with inflammatory arthritis and cancer is challenging given concerns around suppressing anti-tumour immunity. Targeted therapies, such as TNF inhibitors, can be safely used in patients with cancer who are in remission, but whether these treatments are safe for individuals with newly diagnosed or active cancer remains unclear.

In a phase III trial, the addition of obinutuzumab to standard therapy for lupus nephritis led to an increase in the proportion of patients with a complete renal response.

Correction to: Nature Reviews Rheumatology https://doi.org/10.1038/s41584-024-01217-2, published online 14 February 2025.

Neutrophil extracellular traps might promote intraocular infiltration of effector CD4+ T cells by inducing endothelial cell senescence in autoimmune uveitis.

Findings show that the resolution of joint swelling in response to treatment with TNF inhibitors varies depending on the location of the joint in psoriatic arthritis.

Two studies provide insights into the function of TASL in the pathogenesis of systemic lupus erythematosus and highlight the therapeutic potential of targeting this protein.

The first expert consensus recommendations for the treatment and diagnosis of adult sterile bone inflammation have been developed, in which the term ‘chronic non-bacterial osteitis’ is proposed as a disease definition. Will these recommendations pave the way for better diagnosis, management and treatment of this rare disease?

Advances in spatial ‘-omics’, such as transcriptomics and proteomics, have provided vital insights into cartilage microenvironments, revealing cellular diversity, zonal organization and links between cartilage structure and function. Analysing cartilage using spatial ‘-omics’ could deepen the understanding of diseases such as osteoarthritis and guide the development of targeted, disease-modifying therapies

Research demonstrates that the SARS-CoV-2 protein ORF8 drives osteoclastogenesis, establishing a direct link between viral infection and bone loss.

A mouse model that reflects Sjögren disease in humans provides insights into the role of regulatory T cells and type 1 helper T cells in disease pathogenesis.

The detection of anellovirus or eHHV-6B genomes in the blood virome seems to correlate with the risk or severity of rheumatic diseases and COVID-19.

A study implicates the Hes1–Piezo1 signalling pathway in osteocytes in the pathogenesis of glucocorticoid-induced osteoporosis and demonstrates the beneficial effects of Yoda1, a Piezo1 agonist.

In 2024, studies using more advanced methods to calculate the minimal important change have described how different methods and timings of estimating minimal important changes can affect the estimates.

In a phase III clinical trial of abatacept for idiopathic inflammatory myopathy, the primary endpoint was not met but the results suggest abatacept could have benefits in some subtypes of the disease.

Synovial dendritic cell profiles and localization patterns provide insights about the roles of dendritic cell subsets in the initiation, remission and relapse of rheumatoid arthritis.

In a new study, inhibition of CDK7 disrupted the RNA polymerase II transcription cycle, leading to anti-inflammatory effects and metabolic reprogramming in macrophages and attenuation of arthritis in mouse models.

The updated 2023 EULAR recommendations for treatment of systemic sclerosis bring notable changes to recommendations for skin, peripheral vascular disease, interstitial lung disease and pulmonary arterial hypertension therapies, based on newer evidence. These updates provide the first glimmer of personalized patient management.