Recent advances in rheumatology

Kimberly Legault, MD, MSc, is an associate professor of medicine in the Division of Rheumatology at McMaster University.

If you were to name the 3 most important recent advances in rheumatology that are relevant for everyday practice, what would they be?

I think that the 3 most recent, or relatively recent, advances in rheumatology that I can think of would be the introduction of Janus kinase (JAK) inhibitors, which were initially used for rheumatoid arthritis, to have recently been found to have efficacy in a wide variety of rheumatological conditions. They’re being used in psoriatic arthritis, ankylosing spondylitis, and in some forms of dermatomyositis. I do think that those have been quite impressive new molecules for us. There have been issues, including some concerns with cardiotoxicity, etc; however, their efficacy is still quite impressive and I think they have a really big role to play in a lot of our rheumatological conditions.

The second one would probably be the newer classification of inflammatory myositis. Previously we had dermatomyositis and we differentiated that from various forms of polymyositis. However, in the last decade we’ve really seen a differentiation of different subtypes of myositis that is based on novel autoantibodies that have been found. I think that has really revolutionized our thinking and will probably lead to improved therapeutics in inflammatory myositis.

The third [advance] that I can think of is the improvement in therapeutics in connective tissue disease–associated interstitial lung disease. I think that there are a variety of different therapies in different classes that are really up-and-coming and give a lot of newer options to patients who otherwise had very difficult-to-treat disease.

Those are probably the 3 [advances] that I can think of that have been new developments, exciting changes in the most recent years.