A drug to rival methotrexate, advances in T-cell biology and the cross-talk between the nervous system and the immune system were last year’s key highlights in RA research, according to past EULAR president Professor Paul Emery.
In a year in review article for Nature Reviews Emery, a rheumatologist at Leeds Institute of Rheumatic and Musculoskeletal Medicine said that as the development of monoclonal therapies reaches a plateau, work was now moving on to investigate ‘more fundamental aspects of the disease.
The three papers highlighted in his article ‘represent a mixture of perspectives’, he said.
Emery’s top three:
- A study from Harvard discusses a phenomenon recognized for 70 years — the ‘arthritis sparing’ effect of denervation. The mouse model of hemiplegic RA, using nerve transection and K/BxN serum transfer, explains the basis of the ‘arthritis’ sparing effect of denervation and hints that regulation of vascular biology might be a target for disease modifying therapy.
- A study from Japan might be important for determining the optimal management of patients, says Emery. The conversion of FOXP-3-unstable regulatory T (T REG) cells into type 17 T helper (TΗ17) cells is a newly described element of the pathogenesis of RA.
- A phase III Korean led study published in NEJM provides hope that orally-administered tofacitinib is an effective therapy for RA.
“Overall, there is an important pipeline for therapies for RA, particularly oral JAK inhibitors; and the future outcomes for patient’s should continue to improve as a consequence,” Emery concludes.