2025 Guideline Summary for the Treatment of Systemic Lupus Erythematosus

In recognition of Rheumatic Disease Awareness Month this September, this episode explores the critical yet often underutilized role of exercise in the management of rheumatic diseases. We examine how structured movement—ranging from step counts to resistance training—can significantly alter the trajectory of pain, function, and overall disease progression. Our discussion offers practical strategies for helping patients integrate physical activity into their daily routines, with a focus on starting gradually and maintaining consistency. We also address the heightened cardiovascular risks associated with rheumatoid arthritis and how targeted exercise interventions can mitigate these risks. Finally, we delve into fall prevention tactics and the use of technology and interdisciplinary care teams to set achievable, patient-centered goals that physical therapists can effectively support.   

It’s been over two decades since the American College of Rheumatology (ACR) last released comprehensive treatment guidelines for systemic lupus erythematosus (SLE), and much has changed. In this episode, we’re joined by Dr. Lisa Sammaritano to discuss the forthcoming 2025 ACR Guidelines for the Treatment of SLE. These updated recommendations reflect a significant evolution in our approach to lupus care, from the growing range of therapeutic options to a stronger emphasis on patient engagement and minimizing steroid toxicity. We’ll dive into how the guidelines tailor treatment across diverse organ systems and patient populations, and what clinicians need to know to effectively incorporate these updates into their practice. 

In this episode, we’re joined by Karen Durrant, founder of the Autoinflammatory Alliance, who shares her powerful journey from a determined parent seeking a diagnosis for her child to the leader of a global patient advocacy movement. What began as a personal quest has evolved into an international network supporting thousands affected by autoinflammatory diseases. Karen discusses how her collaboration with Dr. Fatma Dedeoglu, a leading pediatric rheumatologist, helped bridge the gap between patient experience and medical research—ultimately contributing to the development of international clinical guidelines that are transforming care for rare disease patients worldwide.  Autoinflammatory Alliance Systemic Autoinflammatory Disease (SAID) Support Autoinflammatory Alliance: Coparison Chart

In this episode, we’re joined by myositis expert Dr. Brian Feldman to explore Juvenile Dermatomyositis (JDM). We cover its clinical presentation, key diagnostic clues, and the workup including labs and imaging. We examine the MDA5 variant, known triggers, and non-pharmacologic management strategies. Dr. Feldman also addresses the high-stakes scenario of JDM-associated rapidly progressive interstitial lung disease, offering insights into pathophysiology, imaging, and aggressive early treatment. The episode concludes with a look at the field’s questions that remain. 

In this episode, we're joined by Dr. Dana DiRenzo to explore groundbreaking developments in the treatment of Sjögren’s Disease. For the first time, therapies like BAFF blockade, CD40 ligand inhibitors, and FcRn antagonists appear poised to change the course of the disease—moving beyond symptom management to potential disease modification. We delve into the underlying science, current clinical trials, and tackle the big question: how early is early enough to begin treatment? Dr. DiRenzo also shares her expert perspective on holistic symptom management through what she calls the "4 Pillars of Health," offering practical strategies for improving quality of life for those living with Sjögren’s. 

In this episode, we take the leap from the structured world of rheumatology fellowship into the dynamic, often unpredictable landscape of private practice. Dr. J. Thomas Berry shares his personal journey, offering an honest and insightful look at the transition. From the practical differences between academic and private settings to the business learning curve, patient care dynamics, and how he stays clinically sharp, this conversation is a must-listen for fellows preparing to enter independent practice 

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.