Top

Current Rheumatology Reports

Published in:

01-05-2017 | Complementary and Alternative Medicine (S Kolasinski, Section Editor)

Platelet-Rich Plasma for the Management of Hip and Knee Osteoarthritis

Authors: Kim L. Bennell, David J. Hunter, Kade L. Paterson

Published in: Current Rheumatology Reports | Issue 5/2017

Abstract

Purpose of Review

Knee and hip osteoarthritis (OA) are major public health problems worldwide causing pain, disability and impaired quality of life. This narrative paper discusses platelet-rich plasma (PRP) as a treatment for hip and knee OA, with a focus on evidence from randomised controlled trials (RCTs).

Recent Findings

Since the first RCT of PRP in 2012, there has been 15 RCTs in knee OA and three in hip OA, mostly comparing PRP to another intra-articular injection therapy, hyaluronic acid. All studies are of low to moderate methodological quality and use variable PRP protocols. In general, results showed that PRP is a safe treatment with potential to provide symptomatic benefit for OA at least in the short term (up to 12 months). Younger patients with less severe disease may be more responsive. There are no RCTs investigating the effects of PRP on OA structural changes.

Summary

No definitive conclusions can be made about the effects of PRP in OA given methodological concerns and considerable heterogeneity between studies. Further high-quality research is needed to establish the clinical and cost-effectiveness of PRP, the patients most likely to benefit and the optimal PRP protocol.

Pereira D, Peleteiro B, Araujo J, Branco J, Santos RA, Ramos E. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarth Cart. 2011;19:1270–85. doi:10.1016/j.joca.2011.08.009.CrossRef

Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the Global Burden of Disease 2010 Study. Ann Rheum Dis. 2014;73:1323–30. doi:10.1136/annrheumdis-2013-204763.CrossRefPubMed

Murphy L, Helmick CG. The impact of osteoarthritis in the United States: a population-health perspective: a population-based review of the fourth most common cause of hospitalization in U.S. adults. Orthop Nurs. 2012;31:85–91. doi:10.1097/NOR.0b013e31824fcd42.CrossRefPubMed

United Kingdom National Joint Registry. 12th Annual Report. 2015.

Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarth Cart. 2010;18:476–99. doi:10.1136/ard.2009.113100.CrossRef

Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM. A systematic review of recommendations and guidelines for the management of osteoarthritis: The Chronic Osteoarthritis Management Initiative of the U.S. Bone and Joint Initiative. Semin Arthritis Rheum. 2014;43:701–12. doi:10.1016/j.semarthrit.2013.11.012.CrossRefPubMed

McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthr Cartil. 2014;22:363–88. doi:10.1016/j.joca.2014.01.003.CrossRefPubMed

Skou ST, Roos EM, Laursen MB, Rathleff MS, Arendt-Nielsen L, Simonsen O, et al. A randomized, controlled trial of total knee replacement. N Engl J Med. 2015;373:1597–606. doi:10.1056/NEJMoa1505467.CrossRefPubMed

Boutron I, Rannou F, Jardinaud-Lopez M, Meric G, Revel M, Poiraudeau S. Disability and quality of life of patients with knee or hip osteoarthritis in the primary care setting and factors associated with general practitioners’ indication for prosthetic replacement within 1 year. Osteoarth Cart. 2008;16:1024–31. doi:10.1016/j.joca.2008.01.001.CrossRef

10.

•• Zhu Y, Yuan M, Meng HY, Wang AY, Guo QY, Wang Y, et al. Basic science and clinical application of platelet-rich plasma for cartilage defects and osteoarthritis: a review. Osteoarth Cart. 2013;21:1627–37. doi:10.1016/j.joca.2013.07.017. This paper is a very useful review of the biology of PRP and outlines some of the key early pre-clinical and clinical studies. CrossRef

11.

• Kanchanatawan W, Arirachakaran A, Chaijenkij K, Prasathaporn N, Boonard M, Piyapittayanun P, et al. Short-term outcomes of platelet-rich plasma injection for treatment of osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc. 2016;24:1665–77. doi:10.1007/s00167-015-3784-4. A recent systematic review and meta-analysis that included only RCTs. CrossRefPubMed

12.

Berenbaum F. Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarth Cart. 2013;21:16–21. doi:10.1016/j.joca.2012.11.012.CrossRef

13.

Sundman EA, Cole BJ, Karas V, Della Valle C, Tetreault MW, Mohammed HO, et al. The anti-inflammatory and matrix restorative mechanisms of platelet-rich plasma in osteoarthritis. Am J Sports Med. 2013; doi:10.1177/0363546513507766.

14.

Drengk A, Zapf A, Stürmer EK, Stürmer KM, Frosch K-H. Influence of platelet-rich plasma on chondrogenic differentiation and proliferation of chondrocytes and mesenchymal stem cells. Cells Tissues Organs. 2008;189:317–26.CrossRefPubMed

15.

Muraglia A, Ottonello C, Spano R, Dozin B, Strada P, Grandizio M, et al. Biological activity of a standardized freeze-dried platelet derivative to be used as cell culture medium supplement. Platelets. 2014;25:211–20. doi:10.3109/09537104.2013.803529.CrossRefPubMed

16.

Wu CC, Chen WH, Zao B, Lai PL, Lin TC, Lo HY, et al. Regenerative potentials of platelet-rich plasma enhanced by collagen in retrieving pro-inflammatory cytokine-inhibited chondrogenesis. Biomaterials. 2011;32:5847–54. doi:10.1016/j.biomaterials.2011.05.002.CrossRefPubMed

17.

Akeda K, An HS, Okuma M, Attawia M, Miyamoto K, Thonar EJMA, et al. Platelet-rich plasma stimulates porcine articular chondrocyte proliferation and matrix biosynthesis. Osteoarth Cart. 2006;14:1272–80. doi:10.1016/j.joca.2006.05.008.CrossRef

18.

Ishida K, Kuroda R, Miwa M, Tabata Y, Hokugo A, Kawamoto T, et al. The regenerative effects of platelet-rich plasma on meniscal cells in vitro and its in vivo application with biodegradable gelatin hydrogel. Tissue Eng. 2007;13:1103–12. doi:10.1089/ten.2006.0193.CrossRefPubMed

19.

Anitua E, Sanchez M, Nurden AT, Zalduendo MM, de la Fuente M, Azofra J, et al. Platelet-released growth factors enhance the secretion of hyaluronic acid and induce hepatocyte growth factor production by synovial fibroblasts from arthritic patients. Rheumatology (Oxford). 2007;46:1769–72. doi:10.1093/rheumatology/kem234.CrossRef

20.

Kwon DR, Park GY, Lee SU. The effects of intra-articular platelet-rich plasma injection according to the severity of collagenase-induced knee osteoarthritis in a rabbit model. Ann Rehabil Med. 2012;36:458–65. doi:10.5535/arm.2012.36.4.458.CrossRefPubMedPubMedCentral

21.

Guner S, Buyukbebeci O. Analyzing the effects of platelet gel on knee osteoarthritis in the rat model. Clin Appl Thromb Hemost. 2013;19:494–8. doi:10.1177/1076029612452117.CrossRefPubMed

22.

Pereira RC, Scaranari M, Benelli R, Strada P, Reis RL, Cancedda R, et al. Dual effect of platelet lysate on human articular cartilage: a maintenance of chondrogenic potential and a transient proinflammatory activity followed by an inflammation resolution. Tissue Eng Part A. 2013;19:1476–88. doi:10.1089/ten.TEA.2012.0225.CrossRefPubMed

23.

Lee HR, Park KM, Joung YK, Park KD, Do SH. Platelet-rich plasma loaded hydrogel scaffold enhances chondrogenic differentiation and maturation with up-regulation of CB1 and CB2. J Control Release. 2012;159:332–7. doi:10.1016/j.jconrel.2012.02.008.CrossRefPubMed

24.

Filardo G, Kon E, Roffi A, Di Matteo B, Merli M, Marcacci M. Platelet-rich plasma: why intra-articular? A systematic review of preclinical studies and clinical evidence on PRP for joint degeneration. Knee Surg Sports Traumatol Arthrosc. 2013;9:1–16. doi:10.1007/s00167-013-2743-1.

25.

Sanchez M, Anitua E, Azofra J, Aguirre JJ, Andia I. Intra-articular injection of an autologous preparation rich in growth factors for the treatment of knee OA: a retrospective cohort study. Clin Exp Rheumatol. 2008;26:910–3.PubMed

26.

Cerza F, Carni S, Carcangiu A, Di Vavo I, Schiavilla V, Pecora A, et al. Comparison between hyaluronic acid and platelet-rich plasma, intra-articular infiltration in the treatment of gonarthrosis. Am J Sports Med. 2012;40:2822–7. doi:10.1177/0363546512461902.CrossRefPubMed

27.

Filardo G, Kon E, Di Martino A, Di Matteo B, Merli M, Cenacchi A, et al. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskelet Disord. 2012a;13:229. doi:10.1186/1471-2474-13-229.CrossRefPubMedPubMedCentral

28.

Sánchez M, Fiz N, Azofra J, Usabiaga J, Aduriz Recalde E, Garcia Gutierrez A, et al. A randomized clinical trial evaluating plasma rich in growth factors (PRGF-Endoret) versus hyaluronic acid in the short-term treatment of symptomatic knee osteoarthritis. Arthroscopy. 2012;28:1070–8. doi:10.1016/j.arthro.2012.05.011.CrossRefPubMed

29.

Vaquerizo V, Plasencia MA, Arribas I, Seijas R, Padilla S, Orive G, et al. Comparison of intra-articular injections of plasma rich in growth factors (PRGF-Endoret) versus Durolane hyaluronic acid in the treatment of patients with symptomatic osteoarthritis: a randomized controlled trial. Arthroscopy. 2013;29:1635–43. doi:10.1016/j.arthro.2013.07.264.CrossRefPubMed

30.

•• Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2013;41:356–64. doi:10.1177/0363546512471299. This was the first study to compare PRP to placebo and found superior clinical effects at 6 months. CrossRefPubMed

31.

Raeissadat SA, Rayegani SM, Hassanabadi H, Fathi M, Ghorbani E, Babaee M, et al. Knee osteoarthritis injection choices: platelet-rich plasma (PRP) versus hyaluronic acid (a one-year randomized clinical trial). Clin Med Insights Arthritis Musculoskelet Disord. 2015;8:1–8. doi:10.4137/CMAMD.S17894.PubMedPubMedCentral

32.

Filardo G, Di Matteo B, Di Martino A, Merli ML, Cenacchi A, Fornasari P, et al. Platelet-rich plasma intra-articular knee injections show no superiority versus viscosupplementation: a randomized controlled trial. Am J Sports Med. 2015;43:1575–82. doi:10.1177/0363546515582027.CrossRefPubMed

33.

Angoorani H, Mazaherinezhad A, Marjomaki O, Younespour S. Treatment of knee osteoarthritis with platelet-rich plasma in comparison with transcutaneous electrical nerve stimulation plus exercise: a randomized clinical trial. Med J Islam Repub Iran. 2015;29:223.PubMedPubMedCentral

34.

Gormeli G, Gormeli CA, Ataoglu B, Colak C, Aslanturk O, Ertem K. Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial. Knee Surg Sports Traumatol Arthrosc. 2015; doi:10.1007/s00167-015-3705-6.PubMed

35.

Smith PA. Intra-articular autologous conditioned plasma injections provide safe and efficacious treatment for knee osteoarthritis: an FDA-sanctioned, randomized, double-blind, placebo-controlled clinical trial. Am J Sports Med. 2016;44:884–91. doi:10.1177/0363546515624678.CrossRefPubMed

36.

Lana JF, Weglein A, Sampson SE, Vicente EF, Huber SC, Souza CV, et al. Randomized controlled trial comparing hyaluronic acid, platelet-rich plasma and the combination of both in the treatment of mild and moderate osteoarthritis of the knee. J Stem Cells Regen Med. 2016;12:69–78.PubMedPubMedCentral

37.

Simental-Mendia M, Vilchez-Cavazos JF, Pena-Martinez VM, Said-Fernandez S, Lara-Arias J, Martinez-Rodriguez HG. Leukocyte-poor platelet-rich plasma is more effective than the conventional therapy with acetaminophen for the treatment of early knee osteoarthritis. Arch Orthop Trauma Surg. 2016;136:1723–32. doi:10.1007/s00402-016-2545-2.CrossRefPubMed

38.

Montanez-Heredia E, Irizar S, Huertas PJ, Otero E, Del Valle M, Prat I, et al. Intra-articular injections of platelet-rich plasma versus hyaluronic acid in the treatment of osteoarthritic knee pain: a randomized clinical trial in the context of the Spanish National Health Care System. Int J Mol Sci. 2016;17 doi:10.3390/ijms17071064.

39.

Duymus TM, Mutlu S, Dernek B, Komur B, Aydogmus S, Kesiktas FN. Choice of intra-articular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options. Knee Surg Sports Traumatol Arthrosc. 2016; doi:10.1007/s00167-016-4110-5.PubMed

40.

Paterson KL, Nicholls M, Bennell KL, Bates D. Intra-articular injection of photo-activated platelet-rich plasma in patients with knee osteoarthritis: a double-blind, randomized controlled pilot study. BMC Musculoskelet Disord. 2016;17:67. doi:10.1186/s12891-016-0920-3.CrossRefPubMedPubMedCentral

41.

Battaglia M, Guaraldi F, Vannini F, Rossi G, Timoncini A, Buda R, et al. Efficacy of ultrasound-guided intra-articular injections of platelet-rich plasma versus hyaluronic acid for hip osteoarthritis. Orthopedics. 2013;36:e1501–8.CrossRefPubMed

42.

• Dallari D, Stagni C, Rani N, Sabbioni G, Pelotti P, Torricelli P, et al. Ultrasound-guided injection of platelet-rich plasma and hyaluronic acid, separately and in combination, for hip osteoarthritis: a randomized controlled study. Am J Sports Med. 2016;44:664–71. doi:10.1177/0363546515620383. One of the few RCTs in hip OA and also investigates the effects of PRP alone and in combination with HA. CrossRefPubMed

43.

Di Sante L, Villani C, Santilli V, Valeo M, Bologna E, Imparato L, et al. Intra-articular hyaluronic acid vs platelet-rich plasma in the treatment of hip osteoarthritis. Med Ultrason. 2016;18:463–8. doi:10.11152/mu-874.CrossRefPubMed

44.

• Shen L, Yuan T, Chen S, Xie X, Zhang C. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res. 2017;12:16. doi:10.1186/s13018-017-0521-3. A recent systematic review and meta-analysis that included only RCTs. CrossRefPubMedPubMedCentral

45.

Bannuru RR, McAlindon TE, Sullivan MC, Wong JB, Kent DM, Schmid CH. Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials. Ann Intern Med. 2015;163:365–72. doi:10.7326/M15-0623.CrossRefPubMed

46.

Dold AP, Zywiel MG, Taylor DW, Dwyer T, Theodoropoulos J. Platelet-rich plasma in the management of articular cartilage pathology: a systematic review. Clin J Sport Med. 2014;24:31–43. doi:10.1097/01.jsm.0000432855.85143.e5.CrossRefPubMed

47.

Tietze DC, Geissler K, Borchers J. The effects of platelet-rich plasma in the treatment of large-joint osteoarthritis: a systematic review. Phys Sportsmed. 2014;42:27–37. doi:10.3810/psm.2014.05.2055.CrossRefPubMed

48.

Lai LP, Stitik TP, Foye PM, Georgy JS, Patibanda V, Chen B. Use of platelet-rich plasma in intra-articular knee injections for osteoarthritis: a systematic review. PM R. 2015;7:637–48. doi:10.1016/j.pmrj.2015.02.003.CrossRefPubMed

49.

Meheux CJ, McCulloch PC, Lintner DM, Varner KE, Harris JD. Efficacy of intra-articular platelet-rich plasma injections in knee osteoarthritis: a systematic review. Arthroscopy. 2016;32:495–505. doi:10.1016/j.arthro.2015.08.005.CrossRefPubMed

50.

Chang KV, Hung CY, Aliwarga F, Wang TG, Han DS, Chen WS. Comparative effectiveness of platelet-rich plasma injections for treating knee joint cartilage degenerative pathology: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2013; doi:10.1016/j.apmr.2013.11.006.

51.

Khoshbin A, Leroux T, Wasserstein D, Marks P, Theodoropoulos J, Ogilvie-Harris D, et al. The efficacy of platelet-rich plasma in the treatment of symptomatic knee osteoarthritis: a systematic review with quantitative synthesis. Arthroscopy. 2013;29:2037–48. doi:10.1016/j.arthro.2013.09.006.CrossRefPubMed

52.

Laudy AB, Bakker EW, Rekers M, Moen MH. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. Br J Sports Med. 2014; doi:10.1136/bjsports-2014-094036.PubMed

53.

Campbell KA, Saltzman BM, Mascarenhas R, Khair MM, Verma NN, Bach Jr BR, et al. Does intra-articular platelet-rich plasma injection provide clinically superior outcomes compared with other therapies in the treatment of knee osteoarthritis? A systematic review of overlapping meta-analyses. Arthroscopy. 2015;31:2213–21. doi:10.1016/j.arthro.2015.03.041.CrossRefPubMed

54.

Mishra A, Woodall Jr J, Vieira A. Treatment of tendon and muscle using platelet-rich plasma. Clin Sports Med. 2009;28:113–25. doi:10.1016/j.csm.2008.08.007.CrossRefPubMed

55.

• DeLong JM, Russell RP, Mazzocca AD. Platelet-rich plasma: the PAW classification system. Arthroscopy. 2012;28:998–1009. doi:10.1016/j.arthro.2012.04.148. A useful framework for classifying PRP based on platelet and white blood cell concentration, and activation method. CrossRefPubMed

56.

Filardo G, Kon E, Pereira Ruiz MT, Vaccaro F, Guitaldi R, Di Martino A, et al. Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach. Knee Surg Sports Traumatol Arthrosc. 2012b;20:2082–91. doi:10.1007/s00167-011-1837-x.CrossRefPubMed

57.

•• Riboh JC, Saltzman BM, Yanke AB, Fortier L, Cole BJ. Effect of leukocyte concentration on the efficacy of platelet-rich plasma in the treatment of knee osteoarthritis. Am J Sports Med. 2016;44:792–800. doi:10.1177/0363546515580787. A systematic review that demonstrated the superiority of leucocyte-poor over leucocyte-rich PRP for clinical outcomes in knee OA. CrossRefPubMed

58.

Braun HJ, Kim HJ, Chu CR, Dragoo JL. The effect of platelet-rich plasma formulations and blood products on human synoviocytes: implications for intra-articular injury and therapy. Am J Sports Med. 2014;42:1204–10. doi:10.1177/0363546514525593.CrossRefPubMed

59.

Bausset O, Magalon J, Giraudo L, Louis M-L, Serratrice N, Frere C, et al. Impact of local anaesthetics and needle calibres used for painless PRP injections on platelet functionality. Muscles, Ligaments Tendons J. 2014;4:18–23.

60.

Sibbitt WL, Kettwich LG, Band PA, Chavez-Chiang NR, DeLea SL, Haseler LJ, et al. Does ultrasound guidance improve the outcomes of arthrocentesis and corticosteroid injection of the knee? Scand J Rheumatol. 2012;41:66–72. doi:10.3109/03009742.2011.599071.CrossRefPubMed

61.

Berkoff DJ, Miller LE, Block JE. Clinical utility of ultrasound guidance for intra-articular knee injections: a review. Clin Interv Aging. 2012;7:89–95. doi:10.2147/CIA.S29265.PubMedPubMedCentral

62.

Sibbitt Jr WL, Band PA, Kettwich LG, Chavez-Chiang NR, DeLea SL, Bankhurst AD. A randomized controlled trial evaluating the cost-effectiveness of sonographic guidance for intra-articular injection of the osteoarthritic knee. J Clin Rheumatol. 2011;17:409–15. doi:10.1097/RHU.0b013e31823a49a4.CrossRefPubMed

63.

Sampson S, Reed M, Silvers H, Meng M, Mandelbaum B. Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis: a pilot study. Am J Phys Med Rehabil. 2010;89:961–9. doi:10.1097/PHM.0b013e3181fc7edf.CrossRefPubMed

64.

Halpern B, Chaudhury S, Rodeo SA, Hayter C, Bogner E, Potter HG, et al. Clinical and MRI outcomes after platelet-rich plasma treatment for knee osteoarthritis. Clin J Sport Med. 2013;23:238–9. doi:10.1097/JSM.0b013e31827c3846.CrossRefPubMed

65.

Eckstein F, Charles HC, Buck RJ, Kraus V, Remmers AE, Hudelmaier M, et al. Accuracy and precision of quantitative assessment of cartilage morphology by magnetic resonance imaging at 3.0T. Arthritis & Rheum. 2005;52:3132–26. doi:10.1002/art.21348.CrossRef

66.

National Institute for Health and Care Excellence (UK). Osteoarthritis: Care and Management in Adults. National Clinical Guideline Centre (UK). Clinical Guidelines No. 177. 2014; Feb.

67.

Hochberg MC, Altman RD, Toupin April K, Benkhalti M, Guyatt G, McGowan J, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res. 2012;64:465–74. doi:10.1002/acr.21596.CrossRef

68.

Jevsevar DS. Treatment of Osteoarthritis of the Knee: Evidence‐Based Guideline. Journal of the American Academy of Orthopaedic Surgeons. 2013;21(9):571–576.

Title: Platelet-Rich Plasma for the Management of Hip and Knee Osteoarthritis
Authors: Kim L. Bennell
David J. Hunter
Kade L. Paterson
Publication date: 01-05-2017
Publisher: Springer US
Published in: Current Rheumatology Reports / Issue 5/2017
Print ISSN: 1523-3774
Electronic ISSN: 1534-6307
DOI: https://doi.org/10.1007/s11926-017-0652-x

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Platelet-Rich Plasma for the Management of Hip and Knee Osteoarthritis

Abstract

Purpose of Review

Recent Findings

Summary

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 5/2017

Protein Tyrosine Phosphatases in Systemic Sclerosis: Potential Pathogenic Players and Therapeutic Targets

Lung Transplantation in Patients With Systemic Sclerosis

Treat to Target in Axial Spondyloarthritis: What Are the Issues?

Fatigue in Rheumatoid Arthritis

Diffuse Alveolar Hemorrhage in Autoimmune Diseases

Bone Involvement in Rosai-Dorfman Disease (RDD): a Case Report and Systematic Literature Review

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page