Osteoarthritis of the hip is a leading cause of chronic disability. The cycling and education intervention (CLEAT) trial aimed to compare the clinical and cost-effectiveness of the cycling against hip pain (CHAIN) intervention, a group-based cycling and education programme, with usual physiotherapy care for patients with hip osteoarthritis referred for physiotherapy at a UK hospital.

Immune checkpoint inhibitors (ICIs) have become a cornerstone in the treatment of metastatic melanoma. Several case reports have documented IgG4-related disease (IgG4-RD) as an adverse event following ICI therapy. Here we report the first instance of interstitial nephritis associated with IgG4-RD as an immune-related adverse event (irAE) following ICI treatment.

Pneumococcal vaccination is recommended for patients with rheumatoid arthritis. Because immunosuppressant therapies for rheumatoid arthritis hinder vaccine efficacy, vaccination should be administered before initiating immunosuppressive drugs. We aimed to compare humoral responses in patients with rheumatoid arthritis receiving the pneumococcal 13-valent conjugate vaccine (PCV13) before methotrexate initiation or simultaneously.

To identify modifiable risk factors associated with progression of hearing impairment from a longitudinal cohort of anti-IL-1-treated children and adults with Cryopyrin-Associated Periodic Syndromes (CAPS) and explore real-life barriers to optimal long-term management.

Anti-interleukin-1 therapies are effective for colchicine-resistant FMF, yet data on optimal duration in pediatric patients remain limited. A previous multicentre study showed favourable outcomes with a standardized canakinumab dose extension protocol, though follow-up was short. This study aimed to assess the long-term outcomes of this protocol.

This study aims to examine the indications for paediatric rheumatologists to use biologic therapies in childhood Behçet's disease (BD), as well as the efficacy, safety and remission rates of such treatments. We also compare demographic and clinical characteristics of Turkish and European cohorts.

Combined pulmonary fibrosis and emphysema (CPFE) predicts unfavourable outcomes in systemic sclerosis (SSc). CPFE and emphysema are associated with pulmonary function tests (PFTs) abnormalities. As screening algorithms for pulmonary hypertension include PFTs, we aimed to assess whether CPFE and emphysema affect the performance of the DETECT algorithm to select patients for right-heart catheterization (RHC).

The gut microbiome forms an ecosystem that provides the host with numerous benefits such as digestion with nutrient generation, protection from pathogens and immune system maturation. Alterations in the microbial ecosystem associated with rheumatoid arthritis and spondyloarthritis have led to the gut-joint hypothesis, which postulates that these ecological changes cause immune dysfunction that contributes to the development of arthritis. Mechanisms by which dysbiosis might trigger arthritis include molecular mimicry, dysregulation of mucosal immunity, microbial translocation, production of immunomodulatory metabolites and immune cell trafficking. We discuss the data supporting each of these mechanisms, and highlight misconceptions, limitations and gaps in knowledge. In particular, we advise against the term 'leaky-gut' as the mechanisms and effects on the immune system of intestinal permeability and bacterial translocation are distinct. Nevertheless, rheumatoid arthritis and spondyloarthritis possibly result from the convergence of multiple pathways that could be unique to subgroups of individuals within these diseases. To move the field forward, each mechanism needs to be considered through the use of model organisms and interventional trials, individually and in concert.

ACA-positive interstitial lung disease (ILD) in SSc is traditionally considered less aggressive than anti-topo I antibody (ATA)-positive ILD. However, its clinical profile and prognosis remain poorly defined. We aimed to characterize ACA-associated SSc-ILD and compare it with other serological subsets.

Macrophages regulate inflammatory and fibrotic processes in several autoimmune and inflammatory rheumatic diseases. They are highly plastic cells, shifting within a range of pro-inflammatory and anti-inflammatory or pro-fibrotic phenotypes in response to dynamic interactions with other cells, environmental factors and cytokine signatures. The terms 'M1 macrophages', or classically activated, and 'M2 macrophages', or alternatively activated, were previously used to denote pro- and anti-inflammatory macrophage subsets, respectively, but this classification system has been outdated by in vivo evidence of a continuum of macrophage phenotypes that includes M1-like, M2-like and hybrid phenotypes. Deciphering the specific mechanisms that drive macrophage plasticity and function during the progression of rheumatoid arthritis, psoriatic arthritis, systemic sclerosis, systemic lupus erythematosus, and in synovitis and large vessel vasculitis in polymyalgia rheumatica and giant-cell arteritis, can improve our understanding of disease pathophysiology. Macrophage plasticity is enhanced in synovial tissue in rheumatoid arthritis, fibrotic skin and lung in systemic sclerosis, damaged kidney in systemic lupus erythematosus, and the bursal tissues or large vessels in polymyalgia rheumatica and giant-cell arteritis. Sophisticated transcriptomic analyses have revealed various phenotypic clusters of macrophages in biopsies of affected organs. Moreover, macrophage plasticity seems to be targeted by some standardized drugs used to treat the aforementioned conditions.

Results of the DRESS-PS trial showed that a tapering strategy with TNF inhibitors is non-inferior to continuation of the same TNF inhibitor dose for up to 12 months in patients with psoriatic arthritis and axial spondyloarthritis. This study aimed to describe the effectiveness of TNF inhibitor tapering for up to 24 months in patients who participated in the DRESS-PS trial.