Epidemiology and pathophysiology of osteoarthritis, osteoporosis, gout, and rheumatoid arthritis
Two diseases, clear mechanisms
- Two diseases with the clearest mechanism-to-drug mapping in rheumatology
- Gout - a metabolic disease with an inflammatory endpoint
- Hyperuricaemia -> crystal deposition -> NLRP3 inflammasome -> IL-1beta
- Rheumatoid arthritis - a gene-environment autoimmune disease
- Shared epitope + smoking -> citrullination -> anti-CCP -> synovitis
- *In gout you fix the metabolite; in RA you block the cytokine. Neither works the other way round.*
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