Volume 51, Issue 3, May 2022, Page 173-179.

Volume 51, Issue 3, May 2022, Page 180-185.

Volume 51, Issue 3, May 2022, Page 186-195.

The EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis (AAV)1 are a pillar in the treatment of patients with these diseases worldwide. Hence, it is of the utmost importance that information, especially dosing be correct and therefore reliable. More than in some other rheumatic diseases AAV oftentimes requires treatment from a multidisciplinary team. For physicians from other specialties dosing might not be as familiar as it is for rheumatologists. Statement 7 of the recommendations suggests a dose of Methotrexate with 20–25 mg/kg/week for remission maintenance of AAV. This recommended dose would almost certainly be toxic and lead to complications or even death. Patients die every year from wrong dosing of Methotrexate. I suggest that in the future, before publishing recommendations for the management of rheumatic diseases an additional layer of security be implemented by separate review of every suggested dose of every medication in the publication for mistakes...

The European Alliance of Associations for Rheumatology (EULAR) recommendations for the management of ANCA-associated vasculitis were published online on 23 June 2016.1 The recommendations were cobadged with the European Renal Association. The Article Metrics on the journal website (available from https://ard.bmj.com/content/75/9/1583.altmetrics, accessed on 4 February 2022) record 667 citations and 119 217 downloads. During production, they were circulated extensively among the authors and postproduction in the vasculitis community. Indeed, they are the only set of EULAR recommendations to have been formally voted on by 88 other clinicians besides the task force in a formal validation exercise.2 On behalf of the authors, we thank Dr Scheicht for his kind words as well as for drawing our attention to the typographical error regarding the dose of methotrexate.3 In the text following statement 4 of the recommendations, we mention that methotrexate (20–25 mg/week, oral or parenteral)...

Synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome is a rare and often under-reported autoimmune disease, characterised by prominent cutaneous and articular inflammation.1 SAPHO syndrome is initially classified within spondyloarthritis, whereas recent evidence indicated that it is preferable as a primitive inflammatory osteitis. There are currently no formal evidence-based guidelines regarding the management of SAPHO syndrome, although variable degrees of efficacy of pharmacological therapies have been previously described, including non-steroidal anti-inflammatory drugs, glucocorticoids, disease-modifying antirheumatic drugs, bisphosphonates and even antibiotics.2 Moreover, antitumour necrosis factor (TNF), interleukin (IL)-1 receptor antagonist also showed beneficial effect to the refractory SAPHO patients.3 Nonetheless, treatment failure or paradoxical effect is still frequent in daily practice. Tofacitinib is a potent, Janus kinase (JAK) 1/3 inhibitor, which has been approved to treat immune-mediated diseases (IMDs), including rheumatoid arthritis, psoriatic arthritis and ulcerative colitis.4 In light of the important...