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.

Insights from the composition, structure and development of articular cartilage are key for long-term therapeutic strategies to restore articular cartilage. The authors emphasize that future therapies should replicate the depth-dependent alignment of collagen and its interactions with the extracellular matrix to produce implants that mimic the biomechanical properties of cartilage.

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.

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 for epidemiological research to progress at a faster pace.

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.