Lupus Science and Medicine podcast

In this podcast, Dr. Anna Wolska sits down with Dr. Eric Morand to discuss a groundbreaking effort to improve how lupus treatment success is measured in clinical trials. Dr. Morand explains why existing tools weren't designed for tracking treatment response and describes a rigorous, patient-inclusive Delphi process that narrowed dozens of possible disease aspects down to eight meaningful domains. By involving patients at every step, the new measure focuses on what patients truly feel and function. Early work on defining precise assessments for each domain is underway, with practical use in trials expected by 2026, promising clearer results and faster access to new lupus therapies.   Read the paper published in LSM - https://doi.org/10.1136/lupus-2024-001484  

Lupus nephritis, affecting nearly half of lupus patients, can cause severe kidney damage. Traditionally, high-dose glucocorticoids (~1 mg per kg prednisone) have been used despite significant side effects. In this episode, host Anna Wolska speaks with Dr. Amit Saxena, a rheumatologist and Associate Professor at NYU Langone Health, about his recent research on the use of glucocorticoids in treating kidney disease in lupus. His study pooled standard-of-care arms from several major clinical trials to compare the efficacy and safety of lower versus higher oral glucocorticoid doses—administered after an initial IV steroid pulse—in treating lupus nephritis.   Read the article published in LSM - https://doi.org/10.1136/lupus-2024-001351

Join Dr. Anna Wolska from the Lupus Foundation of America as she talks with Dr. Jim Oates about his recently published study in Lupus Science & Medicine on validating claims-based algorithms in Medicare data to identify SLE and lupus nephritis. Dr. Oates explains how ICD-10 coding and geospatial analysis (via the Lupus Index) can help pinpoint disparities, guide clinical trial recruitment, and reveal how location affects patient outcomes. The conversation covers the varying sensitivity and specificity of different coding algorithms, potential racial differences, and how overlaying socioeconomic and environmental data can shed light on lupus prevalence and improve healthcare resource allocation.   Read the article published in LSM - https://doi.org/10.1136/lupus-2024-001329

Early reduction in proteinuria is a key predictor of improved long-term kidney health in lupus nephritis (LN). In this episode, Dr. Anna Wolska from the Lupus Foundation of America speaks with Drs. Maria Dall'Era and Anca Askanase about a new propensity analysis comparing voclosporin-based triple immunosuppressive therapy to traditional high-dose glucocorticoid regimens. They discuss findings from the AURA-LV and AURORA 1 studies, highlighting the safety benefits and earlier proteinuria reduction seen with voclosporin. Tune in to explore how these insights may shape LN treatment guidelines and improve patient outcomes.   Read the paper published in LSM: https://doi.org/10.1136/lupus-2024-001319

Join Dr. Anna Wolska and Dr. Jordan Roberts, a pediatric rheumatologist, as they explore the use of Rituximab in treating childhood-onset systemic lupus erythematosus (SLE). They discuss key factors for healthcare providers when prescribing Rituximab to children and adolescents, especially for severe cases like lupus nephritis and CNS involvement. Dr. Roberts presents recent research on Rituximab's safety, highlighting increased infection risks and the need for targeted prevention strategies. Tune in for expert insights on the latest advancements, challenges, and future directions in pediatric lupus treatment.   Read the paper published in LSM - https://doi.org/10.1136/lupus-2024-001210

In this episode of the Lupus Science and Medicine podcast, Dr. Megan Clowse, a rheumatologist at Duke University, discusses her research on contraceptive practices in women with lupus. Drawing from the RISE Registry, Dr. Clowse explores the alignment of contraception use with 2020 ACR guidelines, uncovering gaps in documentation and prescription practices. The conversation highlights the importance of reproductive health planning, the various birth control options for women with lupus, and the need for improved patient-doctor communication to ensure safe and effective family planning. Tune in to learn more about the findings and their implications for clinical care.   Read the related paper published in LSM: https://doi.org/10.1136/lupus-2024-001192

Join host Dr. Anna Wolska as she explores a new study in Lupus Science & Medicine on how positive psychosocial factors—such as resilience, self-efficacy, and emotional support—can reduce stress in people with systemic lupus erythematosus (SLE). In this episode, she speaks with Drs. Kimberly DeQuattro and Sarah Patterson about these factors' protective effects, even for those with trauma histories, and discusses the study's implications for patient care and how enhancing these factors can improve outcomes in lupus management.   Read the paper published in LSM: https://doi.org/10.1136/lupus-2023-001060

Join Dr. Anna Wloska from the Lupus foundation of America and Drs. Peter Lipsky and Amerie Grammer as they discuss the effectivenss of krill oil in reducing disease activity in systemic lupus erythematosus. In this episode, our guest highlight the potential therapeutic benefits of restoring omega-3 fatty acids in patients with SLE and the potency and efficacy of omegga-3s found in krill oil versus other sources.   Read the paper published in LSM - https://doi.org/10.1136/lupus-2024-001201

Join Dr. Anna Wolska from the Lupus Foundation of America and Dr. Laurent Arnaud, Professor of Rheumatology at the Department of Rheumatology, University Hospitals of Strasbourg as they discuss systemic lupus erythematosus (SLE) clinical trials. In this episode, Dr. Arnaud highlights the complexities of drug approval processes in lupus, the pivotal role of large-scale phase three randomized trials and critical outcome measures in these trials, from primary endpoints assessing treatment efficacy to secondary and exploratory measures capturing broader impacts on patient health and quality of life.   Read the article: https://lupus.bmj.com/content/11/1/e001114

Join Dr. Anna Wolska from the Lupus Foundation of America as she delves into a groundbreaking discussion with Dr. Stephen Balevic focused on hydroxychloroquine blood levels and understanding medication adherence in lupus patients. In this episode, Dr. Balevic, a rheumatologist and clinical pharmacologist from Duke University, explains the nuances of interpreting hydroxychloroquine levels, the challenges of ensuring patient adherence, and the implications for clinical practice. Discover the latest insights on optimizing lupus treatment and learn about an innovative algorithm to improve adherence monitoring.   Read the related paper: https://doi.org/10.1136/lupus-2023-001090

Join Dr. Anna Wolska and Dr. May Choi as they explore the role of Artificial Intelligence (AI) and Machine Learning (ML) in guiding diagnostic and care decisions for systemic lupus erythematosus (SLE). Dr. Choi delves into key elements of machine learning and its potential impact on improving outcomes, particularly in underserved populations. She also discusses various types of machine learning, such as deep learning, supervised learning, and unsupervised learning, highlighting their respective contributions to enhancing efficiencies within clinical care settings.   Read the related Review published in LSM: https://doi.org/10.1136/lupus-2023-001140

Join Dr. Anna Wolska and Dr. Jim Posada as they delve into the intricacies of RNAse therapy in the management of Systemic Lupus Erythematosus (SLE). In this podcast episode, Dr. Posada describes the groundbreaking study evaluating the efficacy of RSLV-132, a novel RNAse molecule fused to human IgG1 Fc, in reducing chronic inflammation associated with cutaneous lupus. Key findings from the clinical trial reveal that patients with moderate to severe cutaneous disease activity were administered RSLV-132 over a span of six months. Disease activity was evaluated using the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) score and Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). These findings suggest that RNAse therapy may be effective in patients with higher disease activity.   Read the related paper in LSM - https://doi.org/10.1136/lupus-2023-001113

Dr. Anna Wolska engages in a conversation with Dr. Shivani Garg and Dr. Christie Bartels to delve into the development and implementation of HCQ-SAFE. This innovative decision-aid is designed to empower individuals living with lupus to engage in shared-decision making. The authors discuss the importance of streamlining and enhancing shared decision-making dynamics between patients and healthcare providers regarding the utilization of hydroxychloroquine, a cornerstone therapy in lupus. The tool can be accessed through the following link: http://hcqsafe.medicine.wisc.edu/   Read the article: https://doi.org/10.1136/lupus-2023-000935

Dr. Anna Wolska speaks to Dr. Michael Belmont and Devyn Zaminski to discuss the importance of dual dsDNA testing in order to full understand disease activity. In this study, they made the observation that there is a large amount of discordance in anti-dsDNA antibodies assays. Misinterpretation or errors in anti- dsDNA antibody testing could have negative implications on long term outcomes in people living with SLE.   Read the related paper - https://doi.org/10.1136/lupus-2023-001012

Dr. Anna Wolska engages in a discussion with renowned experts, Dr. Catharina Lindholm and Dr. David Jayne, to explore findings from the phase II TULIP Lupus Nephritis trial. This in-depth conversation centers on results from a clinical trial where they evaluated the efficacy of intensified anifrolumab treatment in individuals with active lupus nephritis.   Read the article: http://dx.doi.org/10.1136/lupus-2023-000910

Dr. Anna Wolska sits down with experts, Dr. Michelle Petri and Dr. Nick Ballew, analyzing the effectiveness of SLE treatments Belimumab and Anifrolumab. The conversation delves into their meticulous study, where they examined the 52-week SLE Responder Index (SRI)-4 responses, providing crucial data for informed lupus patient care. The study data, based on rigorous randomized trials and systematic literature reviews, offers clinicians invaluable insights into treatment decisions for people living with lupus.   Read the published article: http://dx.doi.org/10.1136/lupus-2023-000907

Dr. Anna Wolska from the Lupus Foundation of America interviews Drs. Ana Malvar and Brad Rovin. They discuss using repeat tissue biopsies to understand progression of lupus nephritis over time. They offer conjecture that both immunosuppression as well as mitigation of tissue fibrosis, resulting from inflammatory resolution, are needed in order to preserve kidney function and prevent progression to kidney failure.   Read the related article - http://dx.doi.org/10.1136/lupus-2023-000932

Dr. Anna Wolska from the Lupus Foundation of America interviews Drs. Anca Askanase and Joan Merrill, the developers of the LFA-REAL tool. Together, they discuss the importance of using a tool like LFA-REAL to understand how clinician and patient reported outcomes are essential for understanding efficacy and effectiveness of experimental therapeutics developed to treat people living with lupus.   Read the article: http://dx.doi.org/10.1136/lupus-2022-000875

Dr. Anna Wolska from the Lupus Foundation of America interviews Dr. Amrie Grammer and Dr. Peter Lipsky from AMPEL BioSolutions. Together they describe the molecular endotypes of Type 1 and Type 2 Systemic Lupus Erythematosus. This episode uncovers the distinct molecular profiles of these SLE types and paves the way for personalized treatment approaches based on these classifications.   Link to published paper: https://lupus.bmj.com/content/10/1/e000861

Dr. Anna Wolska from the Lupus Foundation of America interviews Dr. Ian Bruce, from the University of Manchester in the UK. Dr Bruce discusses the time to onset of clinical response to Anifrolumab in patients with Systemic Lupus Erythematosus. The episode delves into pooled data from two significant Phase III trials, TULIP-1 and TULIP-2, offering listeners a deep understanding of the effectiveness and timeline of Anifrolumab treatment.   Read the article: http://dx.doi.org/10.1136/lupus-2022-000761

Dr. Anna Wolska from the Lupus Foundation of America interviews Dr. Andrea Fava from Johns Hopkins University about Belimumab treatment in lupus nephritis. Dr Fava elucidates on the correlation between the decrease in urinary CD163 levels and the response to Belimumab treatment in Lupus Nephritis trials. The conversation provides important insights into the efficacy of this treatment option and potential biomarker use for personalized and precision medicine in the future.   Read the article: dx.doi.org/10.1136/lupus-2022-000763

Dr. Anna Wolska from the Lupus Foundation of America interviews Dr. Andrea Fava from Johns Hopkins University about Belimumab treatment in lupus nephritis. Dr Fava elucidates on the correlation between the decrease in urinary CD163 levels and the response to Belimumab treatment in Lupus Nephritis trials. The conversation provides important insights into the efficacy of this treatment option and potential biomarker use for personalized and precision medicine in the future. Read the article: http://dx.doi.org/10.1136/lupus-2022-000763

Duane Peters from the Lupus Foundation of America interviews Dr Gary Gilkeson from the Medical University of South Carolina about a phase I trial into the use of mesenchymal stromal cells (MSC) in refractory lupus patients in the USA, following impressive results of clinical improvement resulting from this therapy in China. The trial indicated that infusions of MSCs derived from the umbilical cord are safe and may be effective in treating mild to moderate systemic lupus erythematosus, with minimal adverse effects. Access the article: http://dx.doi.org/10.1136/lupus-2022-000704

Duane Peters from the Lupus Foundation of America interviews Dr Peter Izmirly from New York University and Dr Elizabeth Ferucci from the Alaska Native Tribal Health Consortium, both in the USA. They discuss the establishment of a network of population-based lupus patient registries in the USA and how these have been used to estimate the incidence rate of systemic lupus erythematosus using standardised data stratified by sex, race and ethnicity. Access the article: https://lupus.bmj.com/content/8/1/e000614

Duane Peters from the Lupus Foundation of America interviews Professor Ronald van Vollenhoven from the Amsterdam University Medical Centers in the Netherlands and Dr Cynthia Aranow from the Feinstein Institute for Medical Research in New York, USA. They discuss the efforts of the DORIS international task force to agree on a single definition of remission in systemic lupus erythematosus, which they hope will ensure that clinicians, patients and researchers in the field are all working towards the same outcome. Access the article: https://lupus.bmj.com/content/8/1/e000538

Duane Peters from the Lupus Foundation of America talks to Dr Cristina Drenkard from Emory University and Dr Teresa Brady from Clarity Consulting and Communications, both based in Atlanta, USA. They discuss their paper on the relationship between levels of self-efficacy and health behaviours and outcomes in black women with SLE. Their study specifically evaluated the associations between age, educational level and depression in SLE patients and the degree of pain and fatigue they experienced. These findings may help predict who might benefit most from self-efficacy-enhancing interventions to improve quality of life. Access the article: https://lupus.bmj.com/content/9/1/e000566

Duane Peters from the Lupus Foundation of America talks to Dr Sylvia Kamphuis and Dr Javad Wahadat from the Erasmus Medical Center in Rotterdam in the Netherlands about aiming for a Low Lupus Disease Activity State (LLDAS) in children with systemic lupus erythematosus (SLE). They outline the difference between LLDAS and clinical remission (CR), and discuss how LLDAS may be a more achievable target for patients than CR that nevertheless still brings significant clinical benefits in terms of decreasing damage accrual and improving health-related quality of life. Access the paper here: https://lupus.bmj.com/content/8/1/e000571

Duane Peters from the Lupus Foundation of America interviews Professor Iryna Kulyk from Indiana University in the USA and Professor Martin Kriegel from the University of Münster in Germany and Yale University in the USA. They discuss their study, presented at the Lupus 21st Century conference in September 2021, on the influence of the consumption of resistant starch (a type of dietary fiber) on the composition of the gut microbiota of lupus patients. Access the abstract here: https://lupus.bmj.com/content/8/Suppl_2/A63.2.abstract

Duane Peters from the Lupus Foundation of America interviews Dr Erik Anderson and Dr Meggan Mackay from the Feinstein Institutes for Medical Research in New York in the USA. They discuss their study into imbalances in quinolinic acid and kynurenic acid levels in the brain in SLE patients, and propose that the ratio between these two metabolites could be used as a new biomarker or therapeutic target for cognitive dysfunction. Access the paper here: https://lupus.bmj.com/content/8/1/e000559

Duane Peters from the Lupus Foundation of America interviews Jennifer He from the University of Western Ontario in Canada about her research into using neuropsychological battery tests to determine the degree of cognitive dysfunction in lupus patients. A high degree of variability in performance across multiple tests (a high dispersion score) is associated with a higher risk of cognitive dysfunction, so this can be a useful screening/diagnostic tool. Access the paper here: https://lupus.bmj.com/content/8/1/e000511

Duane Peters from the Lupus Foundation of America interviews Dr Jill Buyon, one of LSM's Editors-in-Chief, about the highlights of ACR Convergence 2021, which was held virtually on 3-9 November (https://www.rheumatology.org/Annual-Meeting).

Duane Peters from the Lupus Foundation of America interviews Francisca Lambert-Fliszar and Dr Evelyne Vinet from McGill University Health Centre in Canada. They discuss monitoring 6-mercaptopurine (6-MP) metabolite levels to enable personalisation of immunosuppressive therapies prior to conception or during pregnancy, in order to most effectively and safely control the disease during this critical time. Access the paper here: https://lupus.bmj.com/content/8/1/e000519

Duane Peters from the Lupus Foundation of America interviews Dr Jim Oates from the Medical University of South Carolina and Ralph H. Johnson VA Medical Center in Charleston, USA. They discuss his paper on developing risk prediction models in lupus nephritis to predict outcomes at the point of diagnosis, which can be used as a decision support tool to help inform treatment strategies for patients. Access the paper here: https://lupus.bmj.com/content/8/1/e000489

Duane Peters from the Lupus Foundation of America interviews Dr Ronald von Vollenhoven, one of LSM's Editors-in-Chief, about the highlights of the 14th International Congress on Systemic Lupus Erythematosus (LUPUS 2021) and the 6th International Congress on Controversies in Rheumatology and Autoimmunity (CORA). These events were held jointly as a virtual congress on 6-9 October 2021 (https://lupus2021.kenes.com) and showcased the best clinical, biological, and translational advances in the field of SLE and autoimmunity.

Duane Peters from the Lupus Foundation of America interviews Dr Jill Buyon, one of LSM's Editors-in-Chief, and Dr Philip Carlucci from New York University in the USA, a previous recipient of the LFA's Gina M. Finzi Memorial Student Summer Fellowship. They discuss their recent paper on the safety of kidney biopsies in patients with SLE enrolled in the Accelerating Medicines Partnership in the USA, which aims to identify potential targeted treatments for lupus nephritis. Access the paper here: https://lupus.bmj.com/content/8/1/e000522

Duane Peters from the Lupus Foundation of America interviews the Lupus Science & Medicine Editors-in-Chief, Professor Jill Buyon and Professor Ronald van Vollenhoven. They discuss the recent release of LSM's first Journal Impact Factor™, explaining how it has been calculated, and what it means for the journal, its authors and readers. Access all the LSM journal metrics: https://lupus.bmj.com/pages/top-cited-articles/ and https://lupus.bmj.com/pages/about/.

Duane Peters from the Lupus Foundation of America interviews Dr Stephen Balevic, Dr Rachel Randell and Professor Laura Schanberg from Duke University in the USA. They discuss the advantages and challenges of designing and implementing self-controlled clinical trials for paediatric lupus patients in a home setting, based on their experience of conducting the Individual Patient Exposure and Response in Pediatric Lupus (iPERSONAL) trial. Could this be a way to effectively deliver clinical trials in a post-pandemic world? Access the paper here: https://lupus.bmj.com/content/8/1/e000494

Duane Peters of the Lupus Foundation of America follows up with Professor Ronald van Vollenhoven of the Amsterdam University Medical Centers to discuss the highlights of the lupus research presented at the EULAR 2021 eCongress, which was held virtually on 2-5 June 2021. EULAR Congress website: https://congress.eular.org/index.cfm EULAR 2021 abstracts: https://ard.bmj.com/content/80/Suppl_1

Duane Peters from the Lupus Foundation of America interviews Professor Eric Morand from Monash University in Australia and Dr Raj Tummala from AstraZeneca in the USA about phase II and III trials of the human monoclonal antibody anifrolumab. Their pooled analysis of data from the MUSE, TULIP-1 and TULIP-2 trials showed that, in addition to demonstrating efficacy in adults with moderate to severe systemic lupus erythematosus (SLE), anifrolumab was generally well tolerated with an acceptable safety profile. Anifrolumab was associated with an increased incidence of herpes zoster and respiratory tract infections and a lower reported rate of SLE worsening. This positive benefit–risk profile means that anifrolumab is a potential new treatment option for SLE. Access the paper here: https://lupus.bmj.com/content/8/1/e000464

Duane Peters from the Lupus Foundation of America interviews Dr Susan Manzi from the Allegheny Health Network and Kathleen Arntsen from the Lupus and Allied Diseases Association, both based in the USA, about the Addressing Lupus Pillars for Health Advancement (ALPHA) Project. The ALPHA Project is the first global initiative to identify, prioritise and address top barriers in lupus impacting diagnosis, care, treatment and research. The diverse team includes lupus experts, clinicians, researchers, industry representatives, advocacy organisations and people with lupus, and there is a specific focus on the patient perspective. Access the paper here: https://lupus.bmj.com/content/8/1/e000433

Duane Peters of the Lupus Foundation of America follows up with Professor Ronald van Vollenhoven of the Amsterdam University Medical Centers to discuss the highlights of the 10th Annual Meeting of the Lupus Academy, which was held virtually on 16-18th April 2021. Lupus Science & Medicine is the official journal of the Lupus Academy and the abstracts from the event have been published as a supplement to the journal. Lupus Academy website: lupus-academy.org/ Lupus Academy 2021 abstracts: lupus.bmj.com/content/8/Suppl_1

Duane Peters of the Lupus Foundation of America interviews Professor Ronald van Vollenhoven of the Amsterdam University Medical Centers about the 10th Annual Meeting of the Lupus Academy, which will be held virtually from 16-18th April 2021. As well as his role as co-Editor-in-Chief of Lupus Science & Medicine, Professor van Vollenhoven is a member of the Lupus Academy Steering Committee and has been involved in the planning and development of the 10th Annual Meeting. Participation in the event is free but registration is required. Lupus Science & Medicine is the official journal of the Lupus Academy and the abstracts from the event have been published as a supplement to the journal. Lupus Academy website: https://lupus-academy.org/ Lupus Academy 2021 abstracts: https://lupus.bmj.com/content/8/Suppl_1