The TULIP Study, Three Years On

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. 

Pulmonary hypertension (PH), being a serious complication of systemic sclerosis (SSc), develops late in the course of SSc and carries with it a poor prognosis. With the median survival of about 3 years, new evidence suggests that early diagnosis and treatment can significantly improve survival. Joining us this week is Christopher P Denton PhD FRCP, senior author of “Dynamic Prediction of Pulmonary Hypertension in Systemic Sclerosis Using Landmark Analysis,” published in Arthritis and Rheumatology. Dr. Denton’s latest study explores “the prediction of short-term risk for PH using serial pulmonary function tests (PFTs)” 

Dr. Joshua Baker, first author of a paper recently published in “Arthritis & Rheumatology”, “Associations Between Low Serum Urate, Body Composition, and Mortality“, is our guest today. Dr. Baker, recognizing the controversy in whether low serum urate or uric acid (UA) level contribute to adverse outcomes, set out to evaluate the relation between low serum UA levels and sarcopenia, to assess whether sarcopenia confounds associations between these low levels and mortality. 

When rheumatology concepts battle it out in a team bracket tournament, you get “Rheum Madness”! “A place for everyone who is crazy about rheumatology to connect, collaborate and compete” in an online, learning experience, created by Dr. David Leverenz. His body of work, “Rheum Madness: Creating an Online Community of Inquiry”, featured in this episode, analyzes participant engagement and the presence of the online community of inquiry within its first year. Dr. Leverenz is an educator and rheumatologist at Duke University. He has a growing body of work in Medical Education. He recently completed a Clinician Scholar Educator award from the Rheumatology Research Foundation to create “Rheum Madness” 

Osteoarthritis is incredibly common, affecting more than 500 million people across the globe. It is a significant cause of pain and disability and carries high healthcare costs and societal burdens. Around the world, there are not enough rheumatology specialists to treat all the patients with OA, and in many countries, OA management is coordinated by primary care internists. However, despite good guidelines recommending first-line evidence-based treatments with muscle strengthening, physical activity, weight loss, and judicious medication management, there are many inconsistencies in OA care delivery. This week, we focus on the manuscript “Effectiveness of a New Service Delivery Model for Management of Knee Osteoarthritis in Primary Care: A Cluster Randomized Controlled Trial” and our guest is Dr. David Hunter, its first author. 

In this week’s episode, we’ll be looking at a paper recently published in “ACR Open Rheumatology” titled: “Machine Learning Applied to Patient-Reported Outcomes to Classify Physician-Derived Measures of Rheumatoid Arthritis Disease Activity“. This study used machine learning tools to investigate whether longitudinal patient-reported outcome data can be a proxy for Clinical Disease Activity Index (CDAI), presenting interesting findings that may impact the practice of rheumatology.  Our guest this week is the paper’s first author, Dr. Jeffrey Curtis. Dr. Curtis is the Marguerite Jones Harbert – Gene V. Ball Endowed Professor in Rheumatology and Immunology at the University of Alabama at Birmingham. He has many accolades to his name, including being a prior winner of the Henry Kunkel Young Investigator Award and being a member of the American Society for Clinical Investigation. 

This week, we welcome Dr. Ruth Fernandez Ruiz to our show, a physician-scientist and Assistant Professor of Medicine at Weill Cornell Medical College and Hospital for Special Surgery in New York City. Dr. Fernandez Ruiz’s award-winning work focuses on the interplay of genetic variation, type I interferons, and immune dysregulation in lupus. However, her latest study published in “Arthritis & Rheumatology” entitled: Supporting International Medical Graduates in Rheumatology: A Call to Action seeks to understand and draw attention to the challenges and barriers that prevent international medical graduates from coming to the U.S. and practicing medicine in the field of rheumatology.  

Dr. Patricia Katz is our guest this week as she presents her latest study “Sleep Disorders among Individuals with Rheumatoid Arthritis”, recently published in “Arthritis Care & Research”. This study focuses on patients with RA who self-report common sleep problems such as obstructive sleep apnea, restless leg syndrome and short sleep and examines the prevalence of these disorders plus their potential negative health implications. Dr. Katz shares with us her methods, findings and conclusions as well as some career advice on writing an academic paper, what she finds most challenging about it, and what the editorial process looks like for “ACR Open Rheumatology” and what they look for while reviewing and editing manuscripts.