Nature Reviews Rheumatology最新文献

Mixed pain phenotypes in musculoskeletal disorders: mechanisms and management. 肌肉骨骼疾病的混合疼痛表型：机制和管理。

IF 33.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-10-16 DOI: 10.1038/s41584-026-01443-w

Mary-Ann Fitzcharles, Rodrigo Deamo Assis, David W Polly, Steven P Cohen

{"title":"Mixed pain phenotypes in musculoskeletal disorders: mechanisms and management.","authors":"Mary-Ann Fitzcharles, Rodrigo Deamo Assis, David W Polly, Steven P Cohen","doi":"10.1038/s41584-026-01443-w","DOIUrl":"https://doi.org/10.1038/s41584-026-01443-w","url":null,"abstract":"Pain is categorized into three pain phenotypes: nociceptive, neuropathic and nociplastic, with overlapping pain referring to the coexistence of more than one pain phenotype. Overlapping pain occurs in more than one-third of individuals with musculoskeletal conditions, including inflammatory arthritis, osteoarthritis, spinal disorders and soft-tissue conditions. Whereas nociceptive pain is associated with identifiable tissue pathology and often responds to anatomically focused treatments, the presence of an additional pain phenotype, most commonly nociplastic pain, contributes to clinical complexity, poorer responses to conventional analgesics and procedures, and a greater burden of disease. Clinical identification of overlapping pain relies primarily on history-taking and physical examination, as no validated biomarker or widely accessible diagnostic test is currently available. Quantitative sensory testing and patient-reported questionnaires provide evidence of musculoskeletal overlapping pain but remain underutilized in routine practice. Once the underlying condition has been optimally managed, treatment should adopt a biopsychosocial approach that addresses comorbidities such as psychological distress, promotes self-efficacy and healthy lifestyle behaviours, and incorporates cautious use of pharmacological therapies. Effective clinical care requires recognition of overlapping pain as an important contributor to chronic musculoskeletal pain, with implications for treatment selection, including surgical and interventional decision-making, and for optimizing risk-benefit and cost-effectiveness outcomes.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":" ","pages":""},"PeriodicalIF":33.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Emerging therapies for knee osteoarthritis. 膝关节骨关节炎的新疗法。

IF 33.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-10-14 DOI: 10.1038/s41584-026-01441-y

Alice Courties, Tobias Winkler, Philip G Conaghan, Francis Berenbaum

{"title":"Emerging therapies for knee osteoarthritis.","authors":"Alice Courties, Tobias Winkler, Philip G Conaghan, Francis Berenbaum","doi":"10.1038/s41584-026-01441-y","DOIUrl":"https://doi.org/10.1038/s41584-026-01441-y","url":null,"abstract":"Knee osteoarthritis (OA) is the most prevalent form of OA and a leading cause of chronic pain and disability worldwide. Its growing burden, driven mainly by ageing and obesity, is associated with major societal costs and increased cardiovascular mortality. Knee OA is now recognized as a heterogeneous whole-joint disease involving biomechanical, metabolic, inflammatory, osteochondral and neurovascular mechanisms. This complexity helps to explain why existing analgesics have modest efficacy and why disease-modifying OA drug development has repeatedly faltered. The therapeutic landscape is nevertheless evolving rapidly. Emerging symptomatic strategies include incretin-based therapies (semaglutide is the first to show substantial benefits for pain and function), neurotrophin modulation, extended-release intra-articular glucocorticoids, lubricating injectables and image-guided neurovascular interventions. In parallel, candidate disease-modifying OA drugs target cartilage anabolism, Wnt signalling, matrix-degrading enzymes, subchondral bone remodelling, immunometabolic pathways and local gene therapy. Several treatments, including locally administered GLP1 receptor agonists, the anabolic agent TPX-100 and intra-articular IL-1 receptor antagonist gene therapy, have shown encouraging signals, whereas mesenchymal stromal cell therapies have thus far demonstrated inconsistent efficacy across phase III clinical trials, highlighting the need for further standardization of mesenchymal stromal cell products and optimization of patient selection. Recent advances signal a shift towards a more diverse therapeutic landscape for knee OA, with emerging opportunities to target both symptoms and the underlying mechanisms of disease.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":" ","pages":""},"PeriodicalIF":33.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trained immunity in chronic, relapsing and low-grade joint inflammation. 慢性、复发性和低度关节炎症的训练免疫。

IF 33.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-10-12 DOI: 10.1038/s41584-026-01439-6

Brenda Kischkel, Sonia Nasi, Charles Leroy, Leo A B Joosten, Hang Korng Ea

引用次数: 0

Menopause and musculoskeletal health: a call to action. 更年期和肌肉骨骼健康：行动呼吁。

IF 33.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-10-08 DOI: 10.1038/s41584-026-01446-7

Lihi Eder, Iliana C Lega

引用次数: 0

Filgotinib effective across the axSpA spectrum in phase III trial 在III期临床试验中，非戈替尼在整个axSpA谱中有效

IF 33.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-10-05 DOI: 10.1038/s41584-026-01447-6

Sarah Onuora

引用次数: 0

Lactic acidosis in skeletal muscle contributes to sarcopenia 骨骼肌乳酸酸中毒导致肌肉减少症

IF 33.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-10-05 DOI: 10.1038/s41584-026-01448-5

Sarah Onuora

引用次数: 0

Antiphospholipid syndrome: epidemiology and outcomes in the evolving criteria era 抗磷脂综合征：不断发展的标准时代的流行病学和结果

IF 33.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-10-05 DOI: 10.1038/s41584-026-01438-7

Georges El Hasbani,Karen Schreiber,Ignasi Rodríguez-Pintó,Katrien M. J. Devreese,Danieli Andrade,Alí Duarte-García

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Defective mitochondrial RNA surveillance promotes interferon responses in Sjögren disease 线粒体RNA监测缺陷促进Sjögren疾病中的干扰素反应

IF 33.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-10-02 DOI: 10.1038/s41584-026-01444-9

Holly Webster

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miR-590-3p links inflammation and bone destruction in OA miR-590-3p与骨性关节炎的炎症和骨破坏有关

IF 33.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-10-02 DOI: 10.1038/s41584-026-01445-8

Jessica McHugh

引用次数: 0

Single-component imaging and ultrasound-based tools for the assessment of fracture risk 用于评估骨折风险的单组分成像和基于超声的工具

IF 33.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-10-01 DOI: 10.1038/s41584-026-01436-9

Germain Honvo,Nicholas R. Fuggle,Amal Alenad,Olivier Bruyère,Marguerite O’Riordan,Nicola Veronese,Nasser M. Al-Daghri,Majed Alokail,Mylène Aubertin-Leheudre,Gulistan Bahat,Charlotte Beaudart,Christian Brabant,Fanny Buckinx,Nansa Burlet,Etienne Cavalier,Manju Chandran,Cyrus Cooper,Peter Ebeling,Olivier Ethgen,Roger Fielding,Mickaël Hiligsmann,Jean-Marc Kaufman,Ali Mobasheri,Daniel Pinto,François Rannou,Shaun Sabico,Dolores Sanchez-Rodriguez,Jotheeswaran A. Thiyagarajan,René Rizzoli,Jean-Yves Reginster

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