ACR on Air

In this episode, we examine Behcet's Disease—a rare, multisystem inflammatory disorder that continues to challenge traditional frameworks of autoimmunity and vasculitis. Dr. Johannes Nowatzky joins us to discuss the disease's hallmark features, including recurrent mucocutaneous ulcers and ocular involvement, as well as its geographic distribution and genetic associations. We explore the diagnostic difficulties posed by its heterogeneous presentation and symptom overlap with other conditions, and the rationale behind individualized, often multidisciplinary treatment strategies. This conversation offers valuable insights into a condition that remains as enigmatic as it is clinically significant. 

In this episode, we deliver a critical update on the rapidly evolving legislative landscape impacting rheumatology. We explore the intense policy battles shaping the future of the field, including steep Medicare reimbursement cuts threatening the survival of many practices. We also examine the ongoing challenges posed by pharmacy benefit managers (PBMs) and the growing uncertainty around research funding. Joining us is a special guest, Lennie Shewmaker McDaniel, JD, who brings a firsthand perspective from Capitol Hill, shedding light on what it truly takes to advocate for our patients and the profession in today's complex policy environment. 

In this episode, we examine the evaluation of pain in patients with chronic inflammatory arthritis, with particular attention to spondyloarthritis and its clinical overlap with fibromyalgia. We explore why some patients continue to report persistent pain despite well-controlled inflammation, and the importance of distinguishing between active inflammatory disease and centralized pain syndromes such as fibromyalgia. Join us as we unpack the diagnostic nuances that can significantly impact patient care. 

This episode explores the evolving role of GLP-1 agonists in rheumatology, highlighting their potential to influence weight, inflammation, and overall disease activity. Our guest expert unpacks how adipose tissue contributes to systemic inflammation and why managing body weight is crucial in the treatment of rheumatic diseases. We delve into the underlying science, real-world clinical applications, and the exciting future of incorporating GLP-1 therapies into comprehensive rheumatologic care—offering fresh insight into a therapeutic class with game-changing potential. 

In this episode, we dive into the evolving role of AI in rheumatology—exploring how it's already reshaping workflows, enhancing diagnostic accuracy, optimizing treatment selection, and helping us monitor patients remotely. We tackle big questions around bias, control over critical data and whether we're truly ready to let AI serve as our assistants—or even gatekeepers. From addressing workforce shortages to revolutionizing medical research and education, we examine both the promise and the pitfalls of this powerful technology, and why caution must guide its integration into our clinical decisions.

In this episode, we dive into the complexities of IgG4-Related Disease (IgG4-RD), a mysterious and multi-organ condition that continues to challenge both patients and physicians. Back in January 2024, Dr. John Stone introduced us to the emerging landscape of treatments for IgG4-RD, and today, Dr. Matthew Baker joins us to provide an exciting update. With new therapies on the horizon, we explore the role of B and T cell pathogenesis, the limitations of traditional steroid treatments, and the off-label use of rituximab. We also take a closer look at the promising results from the “Mitigate Trial,” which offers hope for future strategies in managing this enigmatic disease. Join us as we discuss the evolving treatment landscape and what lies ahead for those affected by IgG4-RD. 

In this episode, we dive into a fascinating and often overlooked aspect of rheumatology: complications from diabetes that can mimic rheumatic diseases. Dr. Schiopu kicks off the discussion by shedding light on Diabetic Myonecrosis, a painful muscle condition that can be easily mistaken for other rheumatic disorders. We then explore Scleroderma, a skin-thickening muscle disorder that resembles systemic sclerosis (SSC) but has distinct underlying mechanisms. Dr. Schiopu shares invaluable insights on how to approach complex rheumatology consults in the hospital, emphasizing the importance of thoughtful diagnostic reasoning. She also discusses why sometimes the best approach in medicine is to avoid unnecessary tests and treatments, prioritizing patient care and accuracy in diagnosis. 

In this episode, we dive into the cutting-edge advancements presented by Dr. Christopher T. Ritchlin at Convergence 2024, where he shed light on the promising research set to transform the field of rheumatology. Join us as we break down key insights from one of the field's leading experts, exploring the future of precision medicine, the role of TRBV9 cells in axSpA, the impact of sex differences on PsA, and the potential of urinary biomarkers in Lupus Nephritis. Tune in for a fascinating discussion on what's next in rheumatology. 

In this episode, we explore a potential paradigm shift in the treatment of Rheumatoid Arthritis. For years, pharmacologic interventions have been the cornerstone of management, but now a groundbreaking approach is emerging. John Tesser, principal investigator in a pioneering study, discusses the use of an implantable device that stimulates the vagus nerve. By tapping into the body's nervous system to reduce inflammation, this novel approach offers a promising alternative to traditional drug treatments. Tune in to learn how this innovative technology could reshape the future of Rheumatoid Arthritis care. 

In this episode, we explore the unique challenges and considerations in treating older adults, focusing on the need for a different approach to care due to polypharmacy and multimorbidity. We delve into the complexities of managing these patients, emphasizing the importance of understanding frailty—how to assess, prevent, and address it. The discussion also covers late-onset rheumatoid arthritis, its distinction from rheumatoid arthritis, and why it often goes underdiagnosed and undertreated. We introduce the 5 M's framework; a geriatric care model that helps clinicians focus on what truly matters to older adults. Additionally, we address the role of palliative care in rheumatology, highlighting its importance beyond end-of-life care, and provide guidance on shared decision-making with older adults and their families to ensure patient-centered outcomes.   

If you're a healthcare provider or a storytelling enthusiast, you'll enjoy this episode featuring Dr. Jason Liebowitz. A practicing rheumatologist and accomplished writer, Dr. Liebowitz discusses his journey toward becoming a physician-writer, how writing helps him process his experiences, and the art of storytelling in medicine, especially for a wider audience in today's complex healthcare landscape. 

Happy New Year, Dear Listener! We're back for 2025 and have with us Dr. Carol Langford, President of The American College of Rheumatology (ACR) and Dr. Adam Goode, President of The Association of Rheumatology Professionals (ARP) as our guests. In this episode you'll get an in-depth look at the collaborative efforts driving the ACR and ARP, direct from our leadership!   Dr. Langford and Dr. Goode share with us their journeys into leadership, key initiatives for this year and their vision for advancing the field of rheumatology. We'll also discuss workforce shortages, technological advancements affecting our field and fostering a more inclusive community. 

Dr. Pui Y. Lee, a pediatric rheumatologist, leading researcher and clinician, joins us today to lend his insights on Deficiency of Adenosine Deaminase 2 or “DADA 2”. What is this disease and how common is it? What is the underlying pathophysiology, the role of genetic screening and the most useful diagnostic tools? We'll also cover treatment options for DADA 2, the prognosis most patients face, plus the future of research for this condition. 

As 2024 ends, the ACR's Government Affairs Committee looks ahead to the 119th Congress to address key issues in rheumatology. For our second annual legislative and policy update, we're joined by Dr. Lennie McDaniel, head of ACR's Washington DC office, and Dr. Christina Downey, Chair of the Government Affairs Committee, to share insights from their ACR Convergence 2024 session. Topics include Medicare cuts, physician payments, pharmacy benefit managers (PBMs), telemedicine reimbursement changes, and how you can advocate for better outcomes with the ACR. 

We are proud to present the highly anticipated “ACR 2024 Lupus Nephritis Guideline” with First Author and frequent guest, Dr. Lisa R. Sammaritano. A decade in the making, we reflect on the significant advancements in available therapies, the guideline's holistic approach to managing Lupus Nephritis (LN) across all age groups, and include insights on combination therapies, minimizing glucocorticoid use and how to manage the full spectrum of patients with Lupus Nephritis. 

As we continue to highlight sessions from Convergence 2024, we came upon this talk we think you should not miss: Emerging Threats in Rheumatology: Chronic Chikungunya Arthritis and Syphilis Mimicking Rheumatic Diseases. Session presenters, Dr. Jose Kennedy Amaral Pereira and Dr. Daniela DiMarco help us explore the world of emerging threats in rheumatology: specifically, Chikungunya Arthritis and Syphilis. These two experts share insights with us to help diagnose and manage those with these devastating infections and highlight for us how important it is for rheumatologists to remain on high alert for these infections, which can be easily mistaken for more common rheumatic disorders! 

Can Artificial Intelligence (AI) ever replace the clinician or the researcher? Today, we explore the promises and pitfalls of this transformative technology and its implications for rheumatology. From assistance in diagnosis and patient care to its role in research and academic writing, our two guests Dr. Amanda Nelson and Dr. Bella Mehta will walk us through how our field is utilizing AI today and where it may lead in the near future. Most of all, they'll explain how we can harness its power...without getting burned. 

When should we choose rituximab over cyclophosphamide? What role can avacopan play as an adjunct therapy? When is plasma exchange a viable option? How can we effectively navigate steroid tapering? These are just a few of the critical questions we'll explore with our next guest, Dr. Tanaz Kermani, founder and director of the Vasculitis Program at UCLA, a dedicated clinician and active researcher. Join us as we delve into these topics and address the challenges of diagnosing and managing patients with vasculitis. 

Dr. Sara McCoy, rheumatologist and Sjögren's specialist, a “Sjögrensologist”, joins us this week for an in-depth look at Sjögren's Disease. We address how the systemic nature of this disease can affect everything from the lungs to the kidneys, why traditional treatments may not always work, why a patient's antibody profile may hold the key to their disease severity, the use of new biomarkers, the role of advanced diagnostics and ground-breaking developments in the use of stromal cells in treatment and so much more! 

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. 

Our annual preview episode for Convergence is here, and we have AMPC (Annual Meeting Planning Committee) Chair, Dr. Greg Gardner as our guest! Dr. Gardner walks us through this meeting's focus and strategies, which are designed to make ACR24 even more engaging, delivering cutting edge science, more networking opportunities, improved educational experiences and new initiatives to better the lives of our patients. We'll discuss how Convergence has adapted to a post-pandemic era, get a glimpse of “must attend” sessions, and even hear about the new networking lounge and some insider tips to make the most of your stay in Washington D.C. 

What are Inborn Errors of Immunity (IEI) and what should be done if you suspect them? Dr. Bharat Kumar, clinical rheumatologist and allergy immunologist, joins us to lend his insights on what they are, how to identify them in our patients, the challenges in diagnosing them, and how they manifest in a clinical setting. Dr. Kumar also explains how IEI's are caused, their overlap with rheumatic diseases and recent advancements in treatments. 

This week, the ACR is kicking off Rheumatic Disease Awareness Month (RDAM), and we've got Dr. Shah who introduces the concept of self-management, which can help improve the control of rheumatic disease beyond medication and empower our patients to take active roles in the management of them. Dr. Shah also spends time highlighting resources available for self-management and addresses how the ACR is advocating for improved healthcare polices and patient support and what you can do to take part in that process! 

As physicians, ethical challenges are a certainty for us. Some can be spotted easily and avoided, but what do we do when the choices are not obvious, and a path isn't clear? We must trust our tools to fashion a way forward. Today, we discuss some of today's most relevant moral dilemmas with the Chair of the ACR Ethics Committee, Dr. Kelly Weselman. We'll touch on the balance between patient autonomy and medical recommendations, navigating the complexities of access to care and treatment costs, and managing conflicts of interest. At the bottom of the show, we explore the evolving ethical landscape that is influenced by technological advancements and the increasing availability of information. 

Master rheumatologist, Dr. Philip J. Mease, joins us for a deep dive into psoriatic arthritis (PsA). Dr. Mease explains how to diagnose PsA in patients, the latest treatments, his insights on evaluating joint pain, the role of enthesitis and axial involvement and how to differentiate between inflammatory and non-inflammatory causes of joint pain in those with PsA. This was an enlightening discussion with a master physician that we know you'll enjoy! 

To know where you're going, you need to understand where you've been. This week, we asked Adam J. Brown, MD, the host of the Rheumination's podcast, to share with us how understanding the evolution of rheumatology informs his clinical observations. Dr. Brown brings us to the founding of rheumatology and covers the major milestones, discoveries, the ground-breaking pioneers and how this bold legacy has shaped the current state of our field. 

This week, we explore what the field of physical therapy can offer to our patient's care plan. We examine the role of the physical therapist for our patients, the optimal time for a referral, specific interventions, the role of patient education and the importance of communication between rheumatologists and physical therapists. Our guest, Dr. Yaser Salem, a distinguished professor, program director, and active researcher, with over twenty years of experience as an educator, lends insight to the challenges physical therapists face, recent advancements in the field, physical therapy's future in rheumatology and advice for those looking to join the field. This episode is our second installment in our series with ARP (you can find our latest here) 

Is there a future for AI (Artificial Intelligence) in Rheumatology? Technologies such as Chat GPT and Google's Gemini are already reshaping the landscape of medicine. In this discussion, we explore its current impact, particularly in disease diagnosis within fields like radiology. We also delve into its potential: AI's promise to revolutionize personalized medicine, enhancing how patients manage rheumatic diseases, and its role in advancing remote patient monitoring. Additionally, we address critical limitations, including concerns around privacy, security, and ethical considerations, particularly in the context of employing large language models. 

By now, you likely have heard about CAR-T Cell therapy, but what exactly is it? Today, we dive headlong into this topic with Dr. Max Konig. We cover how this therapy works, how CAR-T Cells are made and administered to patients. We discuss the risks associated with this type of therapy, the side effects and their management. Lastly, we'll discuss the rheumatic diseases amenable to CAR-T therapy, those that are not, the costs and ethics involved and what the future may hold for it in rheumatology. Enjoy! 

Internationally renowned Lyme Disease clinician and researcher, Dr. Allen Steere, joins us for a discussion on Lyme Arthritis. Dr. Steere explains the history of this disease, the historical identification of the borrelia spirochete which causes it, how Lyme Arthritis manifests and presents (including why severity can be vary greatly in patients) and explore the current challenges in its diagnosis. We also cover treatment and antibiotic therapies for the disease, what post-treatment syndromes are, how to treat them and how understanding Lyme Arthritis has improved our knowledge of other diseases, such as rheumatoid arthritis.  

Expert researcher and clinician, Dr. Elana Bernstein, is our guest this week as we dive into lung disease brought on by Systemic Sclerosis (SS). We discuss symptoms, diagnosis, how systemic sclerosis affects the lungs, including pulmonary hypertension and interstitial lung disease. Dr. Bernstein, who has dedicated her career to improving patient outcomes in systemic sclerosis, explains her approach to screening for lung disease, plus the latest research and questions that need to be answered. 

This week, Dr. Hausmann takes on Ultrasound in Rheumatology, exploring its use in the field and diagnosing diseases such as Inflammatory Arthritis, Crystaline Arthropathy and Vasculitis. Dr. Minna Kohler, Founder and Director of the Musculoskeletal Ultrasound Program at Massachusetts General Hospital, joins us as our guest. Dr. Kohler discusses how Ultrasound can help therapeutically, what it's like working in an MSK Ultrasound clinic, plus how one can become trained in the use of Ultrasound, what the patient experience is like, the controversies surrounding the use of Ultrasound in rheumatology and what the future holds for it in our field. 

Join us this week as Jon meets with a truly influential woman in the medical field, Dr. Elizabeth Ang, being one of the first pediatric rheumatologists in the Southeast Asian region to receive pediatric rheumatology training and is the Co-Convenor of the Paediatric Rheumatology Special Interest Group of APLAR (Asia Pacific League of Associations for Rheumatology). Beyond this, and so that children with rheumatic disease in the region have the opportunity to be diagnosed and treated, Dr. Ang trains local doctors and shares her knowledge and experience with them in Cambodia, Vietnam, Indonesia and Myanmar. In this episode she and Dr. Hausmann discuss Singapore's healthcare system, access to biologics, cultural barriers to treatment and much, much more. 

Bone health may not be first on the mind when discussing rheumatology, however, Dr. Marcy Bolster believes it plays a vital role in caring for ‘the whole patient'. As such, Dr. Bolster's innovative contributions to the field of Osteoporosis cannot be overstated. She joins us today to discuss the role of the rheumatologist in helping to prevent or treat Osteoporosis, how often it's under-recognized, plus the services she created to help identify, diagnose and treat the condition among patients.  

When a patient is diagnosed with cancer, treatments that force the immune system into overdrive are given in hopes that it will recognize the cancer and destroy it. Unfortunately, this can mean that various Immune Related Adverse Events (IRAEs) can occur. In rheumatology, our treatments are meant to tame an overactive immune system, creating a unique dilemma. Joining us today is Dr. Laura Cappelli, MD, MHS. Dr. Cappelli explains what these IRAEs really are, how they commonly occur, what risk factors exist in their development, the importance of a multidisciplinary approach to treatment and much, much more. 

April is just around the corner, and so is 2024's State-of-the-Art Clinical Symposium (SOTA)! This week, we welcome Dr. Sobia Hassan, Chair of the SOTA Planning Committee and Dr. Ibtissam Gad, Chair of the Fellows in Training subcommittee. We discuss the topics and speakers chosen for SOTA and how they were selected, some highlights including discussions on CAR T Cells, CPPD, and Check Point Inhibitors, what's in store for our Fellows in Training and how you, our listeners, can get involved! If you've not yet registered, be sure to visit the ACR's registration page for all the details you'll need to plan your trip here: State-of-the-Art Clinical Symposium

Join us this week for an insightful and encouraging discussion with Drs. Mandal and Grant, the founders of The Rheumatology Access Expansion Initiative (RAE). RAE is a project designed to support the Navajo Nation, an underserved community with respect to rheumatic disease. Our guests explain how leveraging the established educational model, Extension for Community Healthcare Outcomes (ECHO), was used to remotely train PCPs among the Navajo in the diagnosis and evidence-based treatment of rheumatoid arthritis (RA). 

If there was ever any evidence for the depth of complexity within our own brains, look no further than the placebos and their effects. Both a help and hinderance to the medical community, rheumatology clinicians and researchers can agree that when testing new treatments, the placebo effect is as powerful as it is disruptive. But what is it exactly? How does it work and for which symptoms? Are there symptoms to which this effect is ineffective? How can you diminish the effect? What is the “Nocebo Effect” and what ethics are involved when dealing with placebos? To answer these questions, we've invited Professor Ted Kaptchuk, director of the Harvard-wide Program in Placebo Studies and the Therapeutic Encounter (PiPS) at Beth Israel Deaconess Medical Center in Boston, Massachusetts to be our guest today and tell us all about placebos, their effects and why they work. 

Join us this week for an in-depth discussion on IgG4-Related Disease with one of the premiere researchers in the field, Dr. John Stone. On this episode, Dr. Stone reviews the disease clinical presentation as well as its symptoms, how to make the diagnosis, treatment options, the role of IgG4 and what happens inside the body. Later, we discuss Dr. Stone's research along with his personal journey in the field. 

As the year winds down and a new year is about to begin, looking back sometimes forces us to look ahead. Last month's Convergence 2023 offered an opportunity to do just that: Look Ahead! We've invited the two speakers from the “The Clinical Year in Preview” session, Joan Bathon, MD and Jill Buyon, MD to discuss with us the latest abstracts that are expected to make the biggest waves in the coming year, as they relate to Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE). We discuss a variety of abstracts that include the use of AI, steroid use, hydroxychloroquine dosing, preventing the development of RA in lupus, pregnancy in lupus dosing for methotrexate and much, much more. 

Dr. Hausmann interviews the first author of the 2022 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis Guideline Summary , Mary Beth Humphrey, MD, PhD this week. We discuss what glucocorticoid-induced osteoporosis (GIOP) is and why it's important for people with rheumatic diseases, the need for an updated guideline, how adult and pediatric patients should be screened, risk categorization and much, much more 

We are LIVE from the San Diego Convention Center with Dr. Snow, Dr. Bulbin, and Dr. Phillips, fresh from their presentation at Convergence 2023 regarding the recruitment and retention of our rheumatology workforce!  

Dr. Hausmann, MD interviews our Convergence attendees on the floor of the San Diego Convention Center! Here's your Daily Round Up for Sunday, November 13th 2023

Dr. Hausmann, MD interviews our Convergence attendees on the floor of the San Diego Convention Center! Here's your Daily Round Up for Sunday, November 13th 2023

Award-winning researcher, Dr. Doruk Erkan joins us today with newly published classification criteria for Antiphospholipid Syndrome (APS). Dr. Erkan joins us today with those criteria and why he believes there is sufficient evidence to “Rethink APS”. 

Dr. Hausmann, MD interviews our Convergence attendees on the floor of the San Diego Convention Center! Here's your Daily Round Up for Sunday, November 12th 2023

We welcome Dr. Christina Downey back onto our show, this time LIVE from Convergence 2023! You may remember Dr. Downey from Episode 46: Empathy and Wellness , but today she comes to us in another capacity: in her continuing role as Chair of the ACR's Government Affairs Committee! Listen in as she discusses what our collective voice in Washington has done for our patients in 2023, what are the current issues rheumatology faces “on The Hill” and lastly, what you can do to be heard! Learn more about the ACR's efforts in advocacy at: rheumatology.org/about-acr-advocacy and get involved at: rheumatology.org/get-involved 

The weekend of Convergence 2023 continues! Dr. Sindhu Johnson presented the new 2023 ACR Interstitial Lung Disease Guidelines (which can be found here ) and joins us today as its first author. Learn all about the recommendations, monitoring, how to approach treatment and when to change it as well as what gaps were noticed that inspired the new guidelines and the intent of the guidelines going forward. Enjoy, and we'll see you tomorrow for another great episode at Convergence! 

Welcome to "ACR Convergence on Air" (ACoA)! Our daily coverage of ACR Convergence 2023! First up: what is thrombotic microangiopathy (TMA) and what is its significance for rheumatology? How does TMA present in clinic and what are the challenges in diagnosing it? Chief of the Division of Hematology and Medical Director of the Clinical Coagulation and the Platelet Antibody Laboratories at Duke University, Dr. Thomas Ortel, joins us on the show to explain this and more from his presentation here at Convergence 2023 

ACR Convergence 2023 begins this Saturday! Dr. Hausmann gets on the mic for this short preview to unveil all of the exciting new things you'll hear, all week long, on our podcast! Be sure to wake up with Jon this Saturday morning, and every morning, during this year's Convergence!