ACR Journals On Air

In this episode, we explore a new approach to improving participation in lupus clinical trials by strengthening provider outreach and education. Our guest, Dr. Saira Sheikh of UNC Chapel Hill, discusses the TIMELY study, which focuses on involving healthcare providers and community health workers to better connect patients with trial opportunities. From roundtable discussions to changes in provider behavior, we highlight practical strategies that could improve how clinical trials are conducted. 

In this episode, Dr. Kaur and Dr. Abhishek join us to discuss their recent study on acetaminophen, exploring how it compares to NSAIDs in safety and effectiveness. They break down their use of the Clinical Practice Research Datalink (CPRD), key findings—especially in arthritis patients—and what this means for clinical practice. It's an insightful look at how big data can challenge assumptions about one of the most used pain medications. 

On this episode, we chat with Dr. Sho Fukui about his recent study on rising uric acid levels and what's driving the increase. We dig into the links between weight, obesity, and gout, and hear how a huge health checkup database in Japan helped uncover some eye-opening trends. Dr. Fukui breaks down the findings in simple terms, shares how they compare to older studies like MRFIT, and talks about what they could mean for treatments like GLP-1s. Plus, we get a sneak peek at the exciting research he's working on next! 

In this episode, we're joined by Dr. Atul Deodhar, a leading expert in the field of Axial Spondyloarthritis (AxSpA). Dr. Deodhar shares insights from his groundbreaking research on the pathophysiology, diagnosis, and management of AxSpA, particularly focusing on the efficacy and safety of IV secukinumab. We dive deep into his study, INVIGORATE-1, exploring the methods behind it, including the use of Interactive Response Technology, and the primary and secondary endpoints that shed light on this treatment's impact. We also discuss the latest data on patient preferences for subcutaneous versus intravenous immunomodulators and the implications of these findings. Tune in for an informative and engaging conversation that blends cutting-edge science with thoughtful reflections on patient care. 

This week, we explore the genetics behind the production of antinuclear antibodies (ANA) in individuals without clinical autoimmune disease, using data from the All of Us registry. Our guest, Dr. Mehmet Hocaoglu shares insights into the significance of understanding ANA positivity and its potential genetic underpinnings, highlighting how large-scale genome-wide association studies (GWAS) can predict susceptibility to autoimmune conditions. We cover the study's methodology, the unique All of Us dataset, and the complexities of genetic analysis. Dr. Hocaoglu also discusses his personal journey in rheumatology research, offering advice for aspiring researchers, especially international medical graduates (IMGs).  

In this episode, our host is joined by Dr. Peter Nigrovic, an expert in Macrophage Activation Syndrome (MAS). Dr. Nigrovic, delves into the complexities of MAS. The discussion covers the syndrome's history, diagnostic challenges, mechanisms of inflammation, and the latest treatment strategies, including cytokine blockade, JAK inhibitors, and chemotherapy options. Dr. Nigrovic also reflects on his unique career journey, offering valuable insights into combining clinical practice and research, while sharing his philosophy for a fulfilling life in medicine and science. This episode is a thorough exploration of MAS and provides practical advice for clinicians dealing with this complex syndrome. Macrophage Activation Syndrome 

In this episode we explore the role of Neutrophil Extracellular Traps (NETs) in systemic lupus erythematosus (SLE). Dr. Mariana Kaplan, Chief of the Systemic Autoimmunity Branch at the National Institute of Arthritis Musculoskeletal and Skin Diseases, joins the discussion to break down the complex immunological mechanisms driving lupus, focusing on the contribution of NETs and Low-Density Granulocytes (LDGs) to disease activity and tissue damage. The conversation delves into the potential for these biological markers to improve diagnosis and treatment strategies, particularly in the context of lupus flares and cardiovascular complications. A link to this week's article can be found, here: Exploring the Role of Neutrophil Extracellular Traps in Systemic Lupus Erythematosus: A Clinical Case Study and Comprehensive Review 

In this episode, we sit down with Dr. Victoria Werth, a leading expert in dermatology and autoimmune diseases, to explore the study Understanding the Role of Type I Interferons in Cutaneous Lupus and Dermatomyositis: Toward Better Therapeutics. Dr. Werth delves into the complex immune mechanisms that drive skin manifestations in cutaneous lupus and dermatomyositis, two challenging autoimmune conditions. She explains how Type I interferons contribute to inflammation and tissue damage, and how understanding these pathways could pave the way for more targeted and effective treatment

In this episode, we explore the findings of a groundbreaking study analyzing opioid treatment trends for adults with and without systemic autoimmune and inflammatory rheumatic diseases (SARDs) from 2006 to 2019. The study, based on national data from the United States, sheds light on how individuals with conditions like rheumatoid arthritis, lupus, and ankylosing spondylitis are impacted by opioid use compared to the general population. 

As our weekend here in Washington D.C. draws to an end, we turn our spotlight on an important and timely conversation from the "Sponsoring Women in Science" session. In this episode, we sit down with Dr. Elizabeth Volkmann and Dr. Carol Feghali-Bostwick to explore the challenges women face in advancing their careers in the sciences. Our guests share insights on how to address the barriers that often impede career development for women, discuss strategies for fostering support and mentorship, and highlight the importance of growing awareness around these critical issues.

Get ready for an electrifying episode of Convergence 2024! We're diving deep into the cutting-edge world of autoinflammatory diseases with renowned experts Drs. Grant Schulert and Arthur Kaser. Join us as they unravel the complexities of refractory and complicated systemic juvenile idiopathic arthritis (SJIA). Discover the revolutionary insights into SJIA at the single-cell level, explore the fascinating transcriptional diversity of normal and low-density granulocytes, and learn how groundbreaking approaches like UDON and SATAY-UDON are paving the way for novel disease programs. Don't miss this chance to fuel your passion for innovation in medicine—tune in and ignite your curiosity! 

This week we're joined by two leading experts in gout remissions, Dr. Nicola Dalbeth and Dr. Dansoa Tabi-Amponsah to explore the exciting advances in gout treatment, with a particular focus on Dual-Energy CT (DECT) imaging and its role in achieving gout remission. We dive into how DECT technology is transforming our ability to visualize urate crystals in joints, its implications for patient care, and the potential it holds for long-term gout management and remission. 

In another installment in the ongoing Arthritis & Rheumatology immunology series, guest David S. Pisetsky, MD, PhD, author of Unique Interplay Between Antinuclear Antibodies and Nuclear Molecules in the Pathogenesis of Systemic Lupus Erythematosus, takes us on a deep dive into research in SLE on how the combination of ANAs and immunologically active DNA can create new structures that can promote inflammation throughout the body as well as drive organ inflammation and damage.

This week, our next guest, ACR Master Dr. Joan T. Merrill, joins us to discuss her latest study which endeavored to evaluate the efficacy and safety of upadacitinib and elsubrutinib in those with systemic lupus erythematosus (SLE). Join us for an in-depth analysis of the SLEek Study, its findings regarding the efficacy of these medications and Dr. Merrill's conclusions. 

For those with rheumatic disease, everyday challenges can mean an increase in disease flare. However, research is increasingly pointing to the idea that psychosocial stressors could even heighten the risk of developing rheumatic diseases. Dr. Christine Parks looked deeper into this among those with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in her latest study Life Events, Caregiving, and Risk of Autoimmune Rheumatic Diseases in the Women's Health Initiative Observational Study 

This week, we explore a groundbreaking study on the prevalence of fibromyalgia and widespread pain in patients with psoriatic arthritis with first author and ACR Master, Dr. Philip J. Mease. In his latest article, titled: Prevalence of Fibromyalgia and Widespread Pain in Psoriatic Arthritis: Association with Disease Severity Assessment in a Large US RegistryUID , Dr. Mease explains what the presence of these conditions reveals about disease severity and how they converge. 

As the dawn of the Ai revolution marches on, scientific research and clinical medicine are adopting new and more streamlined ways to investigate and serve our patients. Today, we look at how Ai-driven, large language models (LLMs) might aid our field's researchers in analyzing data from patient interviews. Dr. Bella Mehta, corresponding author of A Novel Approach for Mixed-Methods Research Using Large Language Models: A Report Using Patients' Perspectives on Barriers to Arthroplasty , joins us this week to give us her insights on this this quickly evolving technology and how it can be employed in both the research and clinical setting. 

Genetic conditions, inherited personality traits, brain chemistry...these are but a few of the well-known biological determinants of health and are but a small sample of factors that can determine how severe disease may affect a patient. But what role can social factors play in determining a patient's health? What of the ‘Social Determinants of Health (SDoH)'? Dr. Shivani Garg set out to identify these factors and understand how they play a role in determining the severity of symptoms in those with Lupus Nephritis (LN). What she discovered was that not only do these factors play a significant role, but each one added has a multiplicative effect on the patient's reported outcome! Dr. Garg is our guest today and her study, published in Arthritis Care & Rheumatology titled: Multiplicative Impact of Adverse Social Determinants of Health on Outcomes in Lupus Nephritis: A Meta-analysis and Systematic Review, will be the focus of our discussion. 

The process of weaning our patients off biologic disease-modifying antirheumatic drug (b-DMARD) therapy is not unfamiliar in our clinics. However, when attending to our patients, many complications and questions arise. Specific guidance is needed, but where do we turn? Thankfully, our latest guest, Dr. Paul Emery, may have some answers. His latest study, Predicting Flare in Patients With Rheumatoid Arthritis in Biologic Induced Remission, on Tapering, and on Stable Therapy attempted to “identify predictors of flare in patients in stable b-DMARD–induced clinical remission”. Let's dive in together and see what he and his team have found! 

To better understand the mechanisms that drive antiphospholipid syndrome (APS), Dr. Yu Zuo and his team, evaluated the presence of circulating calprotectin (cCLP) to detect any clinical associations or even the mechanistic role among a cohort of primary APS and aPL-positive patients. Dr. Zuo sits down with us this week to discuss whether calprotectin can be a functional biomarker for those with APS thrombocytopenia and what the future holds for this study's conclusions. 

Benjamin Franklin once said: “An ounce of prevention is worth a pound of cure”. This week, we have the opportunity to see this realized in a recent clinical study entitled, Vitamin D and Marine n-3 Fatty Acids for Autoimmune Disease Prevention: Outcomes Two Years After Completion of a Double-Blind, Placebo-Controlled Trial. Our guest is the study's first author, Dr. Karen Costenbader. She explains the results of this research, which suggests Vitamin D and marine n-3 fatty acids play a significant role in preventing autoimmune disease!  

Caring for our patients means reducing symptoms and occurrences of flare-ups. However, caring for their whole self means a watchful eye on how chronic disease symptoms impact their daily life and mental health. Discovering patterns between depression and anxiety and such chronic diseases, like ankylosing spondylitis, psoriatic arthritis and rheumatoid arthritis, was the focus of Dr. Alyssa Howren's latest study. Today, we take a look at this study, titled: “What Came First?” Population-Based Evaluation of Health Care Encounters for Depression and Anxiety Before and After Inflammatory Arthritis Diagnosis: Disentangling the Relationship Between Mental Health and Arthritis and try to disentangle the web of disease-related depression and anxiety 

When disease strikes, time becomes a critical resource our patients cannot afford to waste. For those with axial spondyloarthritis (axSpA), an inordinate amount of time often goes by before a proper diagnosis is made, resulting in delays for crucial treatments to be rendered. The reasons for this delay in diagnosis, particularly among those with axSpA are diverse, complicated and not well-understood. Our guest, Dr. Gregory McDermott, attempted to better understand this diagnostic delay with his study: Factors Associated With Diagnostic Delay in Axial Spondyloarthritis: Impact of Clinical Factors and Social Vulnerability  in hopes that we may begin answering these challenges with solutions.  

Systemic Sclerosis (SSc) is a painful and debilitating disease that our patients suffer from. However, a newly published study has concluded that there are some self-management interventions patients can engage with that have shown to improve fatigue, particularly for those newly diagnosed with SSc. Today, we review the procedures, interventions, results and conclusions of this study, titled: Effects of a Resilience-Building Energy Management Program on Fatigue and Other Symptoms in Systemic Sclerosis: A Randomized Controlled Trial, along with two of its authors, Dr. Susan L Murphy and Ms. Mary Alore, and how your patients can benefit from its lessons. 

As the need and demand for quality care increases, time in clinic needs to become more efficient. Working smarter, not harder, is a daily challenge for all in our field. With mobile technology streamlining so much and improvements in patient reported outcome (PRO) collection among patients with rheumatoid arthritis (RA) needed, it had Dr. Daniel Solomon asking “...is there an app for that?”. Today, we review the study A Mobile Health Application Integrated in the Electronic Health Record for Rheumatoid Arthritis Patient–Reported Outcomes: A Controlled Interrupted Time-Series Analysis of Impact on Visit Efficiency , recently published in Arthritis & Rheumatology. Our guest, Dr. Daniel Solomon, is our guest and the study's first author. 

Recent research indicates that those who suffer from AxSpA may have some hope in protecting against events of Uveitis! Dr. Katie Bechman, first author Incidence of Uveitis in Patients With Axial Spondylarthritis Treated With Biologics or Targeted Synthetics: A Systematic Review and Network Meta-Analysis, explains her team's research findings and how they came to this exciting conclusion! 

“If I have seen further, it is because I stand on the shoulders of giants” Sir Isaac Newton famously stated in a letter to polymath scientist, Robert Hooke back in 1675. Today, Dr. Mary Crow, MD, aides Arthritis & Rheumatology launch a series on immunology, for rheumatologists. She is the co-author of the article Standing on Shoulders: Interferon Research, from Viral Interference to Lupus Pathogenesis and Treatment. In this episode, we stand with Dr. Crow to look back at the achievements made by brilliant minds in interferon research and analyze the unbroken line their advancements in rheumatology have led to today's discoveries, with more to com

Is there an increased risk of cancer once a patient has Scleroderma? If so, what is the risk and how does one go about showing this? Dr. Ami A Shah, Director of the Division of Rheumatology at Johns Hopkins sits down with us to explain those answers. We go over the methods, results and conclusions of the recent study Distinct Scleroderma Autoantibody Profiles Stratify Patients for Cancer Risk at Scleroderma Onset and During the Disease Course published in Arthritis & Rheumatology. Afterward, Dr. Shah shares with us her journey to becoming a physician-scientist and mentoring others in Scleroderma research through a K24 grant. 

Welcome back to “Journals”! Our topic of discussion today comes from the manuscript Anti-Gephyrin Antibodies: A Novel Specificity in Patients With Systemic Sclerosis and Lower Bowel Dysfunction and our guest today is the study's first author, Dr. Zsuzsanna McMahan. The study recognizes that the enteric nervous system (ENS) regulates the gastrointestinal (GI) function, which is commonly impaired in those who suffer from systemic sclerosis (SSc). Dr. McMahan and her team's objective for this study was “to identify novel anti-ENS autoantibodies with an aim to clinically phenotype SSc GI dysfunction”. We sit down with Dr. McMahan and discuss the study's methods and discoveries. Plus, her experience transitioning from a junior to an independent investigator and what advice she can offer our young listeners for the journey along the way. 

Dr. Tobit Steinmetz is our guest this week, author of the manuscript recently published in “Arthritis and Rheumatology” titled: "Association of Circulating Antibody-Secreting Cell Maturity with Disease Features in Primary Sjogren's Syndrome." Dr. Steinmetz and his team endeavored to better understand the hyperactivity observed among B cells, which play a major role in Primary Sjogren's Syndrome (SS). To do this, he and the team examined the quantity, maturity and inflammatory properties of Antibody Secreting Cells (ASCs) in the B cell effector branch, which became the focus of the study. Tune in to hear how this was done, what their observations and conclusions were plus, Dr. Steinmetz's insights for those looking to enter a postdoctoral position! 

After a major event, it's important to take stock of the causes of such an event, but just as important, on the reactions to it. No other event has challenged humanity in recent memory like COVID-19. Today we discuss the pandemic in relationship to its impact on those who suffer with rheumatic disease and examine the global response. Our guest is Dr. Evelyn Hsieh, MD, PhD, the first author of the paper: Global Perspective on the Impact of the COVID-19 Pandemic on Rheumatology and Health Equity , which was recently published in Arthritis Care & Research. 

Sometimes, we learn more from what isn't achieved than when we achieve an expected result. Such is the case for our next guest, Dr. David R. Jayne, who is the first author of Clinical and Biomarker Responses to BI 655064, an Antagonistic Anti-CD40 Antibody, in Patients With Active Lupus Nephritis: A Randomized, Double-Blind, Placebo-Controlled, Phase II Trial , a study designed to characterize a dose-response relationship between an anti-CD40 monoclonal antibody known as Bi 655064 and complete renal response (CRR) in patients with active lupus nephritis (LN). Dr. Jayne and his research team's study may not have shown this dose-response relationship, but what was gained along the way surely shows the power of the negative study! 

Knowing that glucocorticoids significantly increase the risk of fractures and is the most common cause of secondary osteoporosis, the use of the steroid has always been viewed as a doubled edged sword and “Bad for the Bones”. This week, we welcome Dr. Giovanni Adami, first author of Bone Loss in Inflammatory Rheumatic Musculoskeletal Disease Patients Treated with Low-Dose Glucocorticoids and Prevention by Anti-Osteoporosis Medications , whose goal for this study was to assess if a “safe” dose of glucocorticoids exists, with an attention focus on those with inflammatory rheumatic musculoskeletal diseases (iRMDs) to determine if a low enough dose of glucocorticoids can still reduce inflammatory burden and yet significantly reduce expected risk of fracture. 

The pandemic has changed much in our world—from the way we work, to the way we shop, and even the way we learn. Rheumatology wasn't immune from such changes and when medical institutions needed to adjust their practices to accommodate a changing world around them, the process by which fellowship interviews were conducted needed to change as well. Thus, a shift to the video communication platform Zoom was made. Now, as the pioneering cohorts of the new Zoom matching process graduate, we are joined by Bharat Kumar, MD, MME, FACP, RhMSUS. Dr. Kumar has been doing a lot of research on what went well, what didn't, and what merits rethinking. Dr. Kumar is the first author of the manuscript Reimagining the Rheumatology Fellowship Interview: Using Participatory Design-Thinking Process to Create a More Applicant-Centered Experience.

Our next guest, Dr. Paul Monach, reviews “Complement”, focusing on its application in the clinical setting. In his work, Dr. Monach presents a typical case with a broad differential diagnosis, then provides an overview of the complement system along with clinical diseases with complement-driven mechanisms. Dr. Shanmugam reviews this manuscript published in Arthritis & Rheumatology plus an analysis of the laboratory tests. Later in the show, Dr. Monach gives us his insights on how he combines his clinical work with his translational work in immunology and acts Chief of Immunology at the VA in Boston, Massachusetts! 

End-stage renal disease is a dangerous reality for those who suffer from Lupus Nephritis (LN), despite improvements in immunosuppressive therapy in the last 20 years. Our next guest, Dr. Brad H Rovin, MD, FACP, FASN, is the first author of the manuscript “Kidney-Related Outcomes and Steroid-Sparing Effects in Patients with Active Lupus Nephritis Treated with Obinutuzumab: A Post Hoc Analysis of a Phase 2 Trial.” which was recently published in Arthritis & Rheumatology. This study was a post hoc analysis of the NOBILITY trial and was conducted to assess kidney-related outcomes in patients using Obinutuzumab. 

This week on ‘Journals', we turn our attention to a rare but challenging and heart-breaking complication of rheumatic disease, Congenital Heart Block. Sir Deryck and Lady Va Maughan Professor of Rheumatology and Director of the Division of Rheumatology at New York University School of Medicine, Dr. Jill Buyon joins us today to present her latest research “Prospective Evaluation of Anti-SSA/Ro Pregnancies Supports the Utility of High Titer Antibodies and Fetal Home Monitoring for the Detection of Fetal Atrioventricular Block.”. 

This week on ‘Journals', we'll look at not just one, but two studies that endeavored to define knee osteoarthritis (OA) through magnetic resonance imaging (MRI) imagery. The manuscripts we'll be discussing are:  Development of a Magnetic Resonance Imaging–Based Definition of Knee Osteoarthritis: Data From the Multicenter Osteoarthritis Study   Diagnostic accuracy of candidate MRI knee osteoarthritis definitions versus radiograph in an acute anterior cruciate ligament injury cohort  Our guest is lead author and social media influencer for rheumatology, Dr. Jean Liew, MD, MS (@Rheum_cat) 

This week we welcome our next guest, Dr. John D. Pauling to ‘Journals'. Dr. Pauling is the senior author of the manuscript “Assessment of the Systemic Sclerosis-Associated Raynaud's Phenomenon Questionnaire: Item Bank and Short Form Development”, which endeavored to “develop, refine and score a novel patient-reported outcome instrument to assess the severity and impact of Raynaud's Phenomenon (RP) in Systemic Sclerosis (SSc)”. In this episode, we discuss the challenges associated with measuring one of the most common disease manifestations of scleroderma, Raynaud's, and how the Assessment of Systemic Sclerosis-Associated Raynaud's Phenomenon (ASRAP) questionnaire was harmonious in the paper's results and final conclusions. 

Assessing disease activity in large vessel vasculitis can be a challenge. And as imaging techniques evolve, clinicians must evaluate how to harness new imaging modalities in clinical care. In an attempt to predict the progression of large vessel vasculitis (LVV), our next guest, Dr. Kaitlin Quinn, used the vascular activity seen on a fluorodeoxyglucose-positron emission tomography (FDG-PET) scan to determine if there is an observable association with angiographic change. Dr. Quinn, author of the study Association of 18F-Fluorodeoxyglucose–Positron Emission Tomography Activity With Angiographic Progression of Disease in Large Vessel Vasculitis, breaks down her study and its methods along with her observations and findings for us. 

This week our guest is Dr. Joyce Chang, MD, MSCE, a recipient of the Lupus Foundation of America's “Mary Betty Stevens Young Investigator Award”, who shares her latest study, its methods, conclusions and career journey with us! Dr. Chang's latest study “Improving Outcomes of Pediatric Lupus Care Delivery With Provider Goal-Setting Activities and Multidisciplinary Care Models“ used the pediatric Lupus Care Index (pLCI) and population management strategies for improving outcomes in childhood SLE. Later, we spent some time with Dr. Chang and asked what she sought out in her first faculty appointment and how she ensured she would hit the ground running.

Patients with Rheumatoid Arthritis (RA) need rehabilitation to improve functional limitations and slow disability. But in what doses? Using the FORWARD databank, our next guest Dr. Kaleb Michaud, PhD, identified a cohort and gathered data on rehabilitation dose and their functional outcomes. His study's objective (titled: “Examining Rehabilitation Dose in Adults With Rheumatoid Arthritis: Association With Baseline Factors and Change in Clinical Outcomes“) determine if there was a meaningful change in physical function, pain and fatigue over a six-month period when evaluating baseline factors and rehabilitation dose. This study, recently published in Arthritis Care & Research is the subject of our discussion today. 

Photosensitivity among patients with SLE is a well-known symptom. However, what is not well-known is why. Our guest this week, Dr. J. Michelle Kahlenberg MD, PhD and team, endeavored to uncover that answer. The article, “Regulation of Photosensitivity by the Hippo Pathway in Lupus Skin” was the result of this study, which was published in “Arthritis & Rheumatology” earlier this year. Dr. Kahlenberg joins us for this episode to discuss the study's methods, results and its surprising conclusion: a novel driver was discovered! 

It has only been three years since the start of the COVID-19 pandemic and we're only just now beginning to investigate the impact it has had on our collective societies. The full impact will likely not be known for years to come, if ever. As those studies are beginning, our next guests wanted to evaluate the pandemic's impact in their spheres of interest. First author, Dr. Kristie Kuhn, MD, PhD along with Dr. Liana Fraenkel, MD, MPH and team asked the question: “What is the impact of COVID on our early career investigators and trainees and what can be done about it?”. The results of their study are found in “Impact of the COVID-19 Pandemic on Early Career Investigators in Rheumatology: Recommendations to Address Challenges to Early Research Careers” and were recently published in “Arthritis Care & Research”  

This week, we take a look at the practical management of pain and the advancement of science regarding it, with our guest Dr. Dan Clauw. Co-author of the paper: “Identifying and Managing Nociplastic Pain in Individuals With Rheumatic Diseases: A Narrative Review”, Dr. Clauw joins us today to discuss the work to introduce the three types of pain classified by “The International Association for the Study of Pain” and the mechanisms that underlie pain, as it relates to the field of rheumatology.  

Our guest this week is Dr. April Barnado, the first author of a study which analyzed a cohort of 3.2 million patients with Systemic Lupus Erythematosus (SLE), during pregnancy, from 1989 to 2020. Her team's work, titled “Systemic Lupus Erythematosus Delivery Outcomes Are Unchanged Across Three Decades“ was published in “ACR Open Rheumatology”, and found some amazing trends regarding outcomes of the pregnancies and even in medication use. The study, its methods, conclusions and Dr. Barnado's advice on breaking into academic research, is the focus of our show.  

Our guest this week is Dr. Tony Merriman, whose latest work: “Association of Gout Polygenic Risk Score With Age at Disease Onset and Tophaceous Disease in European and Polynesian Men With Gout“, attempted to determine whether a gout polygenic risk score (PRS) is associated with age at gout onset and tophaceous disease in European, East Polynesian, and West Polynesian men and women with gout. However, what this study found regarding the predictability of these associations, specifically how it affects men and women differently, may have been something no one could have predicted. 

This week we get to “The Heart of the Matter” a little differently. To begin, our guest is the first author of a manuscript whose objective was to determine the prevalence and correlation of subclinical myocardial inflammation in patients with rheumatoid arthritis (RA), titled: “Myocardial Inflammation, Measured using 18-FDG-PET-CT is associated with Disease Activity in Rheumatoid Arthritis“. Her name is Dr. Isabelle Amigues, and her story of survival and reinvention (much like the conclusions of her paper) exemplify how matters of the heart can be far more complex and impactful than they appear. 

Our guest this week, Dr. Alexandru-Emil Matei, is the first author of a study that endeavored to evaluate immune cell activation in scleroderma. His study, written for the completion of his medical training in Romania is titled: “Identification of a Distinct Monocyte-Driven Signature in Systemic Sclerosis Using Biophysical Phenotyping of Circulating Immune Cells“ (recently published in “Arthritis & Rheumatology”) performed biophysical phenotyping of circulating immune cells by employing a novel high-throughput method called ‘real-time fluorescence and deformability cytometry' (RT-FDC). Dr. Matei's study attempts to demonstrate that RT-FDC measures can “detect changes in the biophysical properties of individual immune cell populations in SSc patients”. If demonstrated, then RT-FDC may be used as another tool in identifying pathologic immune cell activation, being that immune cells like monocytes play a major role in systemic sclerosis (SSc).

Caring for older adults who suffer from rheumatic disease comes with it the need to manage multimorbidity, polypharmacy, and geriatric syndromes. Often, shifting priorities for those suffering with rheumatic musculoskeletal diseases (RMDs) is needed, sometimes leading to a prescribing cascade. The practice of ‘deprescribing', an approach to optimize medication use to deliver a more ‘goal-concordant' type of care was the focus of Dr. Una Makris and Dr. Jiha Lee's latest research: “Optimizing Medication Use in Older Adults With Rheumatic Musculoskeletal Diseases: Deprescribing as an Approach When Less May Be More“ When caring for older adults with RMDs, it very well may be, that “Less is More”. 

In a study recently published in “ACR Open Rheumatology” titled: “Geographic Variation in Disease Burden and Mismatch in Care of Patients With Rheumatoid Arthritis in the United States“, first author Dr. Sharon Dowell set out to understand some of the factors associated with regional variation of rheumatoid arthritis in the United States. Sharon Dowell, MD presents her study's findings and conclusions. ACR's RISE Team member, Tracy Johansson, MS, joins us as well to discuss how RISE attempts to close these gaps. Together, both of our guests help us to understand how geographic location contributes to a disproportionate level of care for those with RA and what we can do about it.