The Lancet Rheumatology in conversation with

In August’s episode, Dr Mrinalini Dey from the Centre for Rheumatic Diseases at King’s College London discusses her recent publication on the association between health literacy and outcomes in people with inflammatory arthritis in England. Health literacy—the ability to access, understand, evaluate, and use health information and services in ways that promote and maintain good health and wellbeing—is increasingly recognised as a key factor in promoting health and managing chronic diseases. The World Health Organization has identified health literacy as central to the prevention and control of non-communicable diseases, such as rheumatic and musculoskeletal conditions. As a potentially modifiable social determinant of health, health literacy can influence how patients experience and manage disease. Yet, its relationship with clinical outcomes, mental health, work participation, and broader social factors in inflammatory arthritis remains poorly understood. We discuss the findings from Dr Dey’s large, national cohort study, how we can improve health literacy disparities in patients, and what should be next on the research agenda to tackle this issue. Click here to read the full article: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(26)00081-0/fulltext

In today’s episode Professor Eric Morand discusses the results of Cohort A and Cohort B of the WILLOW trial which investigated the efficacy and safety of enpatoran, a novel, oral small molecule inhibitor of Toll-like receptors 7 and 8 (TLR 7/8) in patients with cutaneous lupus erythematosus (CLE) and systemic lupus erythematosus (SLE). The interferon pathway has been implicated in both CLE and SLE pathogenesis, however, the mechanism through which interferon expression is induced in lupus remains unknown. Targeting TLR 7/8 is of particular interest, as they are key drivers of interferon activation. Enpatoran has previously shown efficacy in early phase 1 trials of patients with CLE and SLE, with improvements in SLEDAI-2K and reduction in IFN-gene signatures with good safety profiles. We also highlight the differences in study design and endpoints of each cohort, compare and contrast enpatoran to currently approved therapies for SLE, anifrolumab and deucravacitinib, and finally, outline what the next research priority should be for patients with CLE and SLE. Click here to read the full articles:  https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00337-6/fulltext and https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00463-0/fulltext

In this month’s podcast, we explore Associate Professor Kragstrup’s recent proof-of-concept study which reports glucagon-like peptide-1 (GLP-1) concentrations and dipeptidyl peptidase-4 (DPP-4) activity in paired plasma and synovial fluid from patients with rheumatoid arthritis and spondyloarthritis and discuss whether there may be potential for intra-articular GLP-1 receptor agonist injections in these patients? GLP-1 receptor agonists are gaining increasing attention in rheumatology due to their immunomodulatory and anti-inflammatory effects, highlighting their role as a potential therapeutic option for patients with rheumatic disease. Whether GLP-1 and DPP-4 (the key regulator of GLP-1) are present in synovial fluid of patients with rheumatic disease and to what extent remains to be seen. Understanding their interplay within the joint may provide more insight on whether GLP-1 receptor agonists could exert direct intra-articular effects in rheumatic disease. We also discuss limitations and barriers of investigating GLP-1 and DPP-4 and the next research priorities for determining the efficacy of GLP-1 receptor agonists in patients with rheumatic disease. Click here to read the full article: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(26)00074-3/fulltext

In this episode, Professor Dirk Foell from University Hospital Münster unpacks the findings from a recent Europe-wide survey examining trends in paediatric rheumatology care. Despite significant scientific advances, delivering consistent, high-quality care for children with rheumatic and musculoskeletal diseases remains a challenge. Drawing on Professor Foell's recent Viewpoint, we discuss variation in paediatric rheumatology training pathways, subspecialty accreditation, and professional recognition across Europe, and how these disparities can impact workforce development and clinical care. Click here to read the full article: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00378-9/fulltext

As part of The Lancet Rheumatology’s special issue on public and patient involvement in rheumatology, in this month’s episode, Aisling talks to Professor Jon Lampa about his recent publication on the patient-reported outcomes from the NORD-STAR trial. The 2023 NORD-STAR trial was the first randomised trial to compare three different biological DMARDs, all in combination with methotrexate with active conventional treatment in patients with early rheumatoid arthritis. The study showed that after 48 weeks remission rates were higher in two of the three (Certolizumab pegol, abatacept, but not tocilizumab) biological DMARDs compared to active conventional treatment and that while radiographic progression was low, it was similar between groups. Providing an interesting insight into the management of patients with newly diagnosed rheumatoid arthritis. Patient-reported outcomes are vital for measuring health, quality of life and treatment impact directly from the patient perspective–and now the data on how these treatments impact patient-reported outcomes is here. We also discuss the importance of reporting patient-reported outcomes in clinical trials, the benefits of including patients and people with lived experience in research and what the future of patient-reported outcome measures looks like. Click here to read the full article: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(26)00007-X/fulltext Medical imaging and theranostics are revolutionising how we diagnose, treat, and understand disease. To meet this moment, The Lancet group is happy to announce the launch of, The Lancet Medical Imaging and Theranostics.  You can visit https://www.thelancet.com/medical-imaging-theranostics to learn more. Continue this conversation on social! Follow us today at... https://thelancet.bsky.social/ https://instagram.com/thelancetgroup https://facebook.com/thelancetmedicaljournal https://linkedIn.com/company/the-lancet https://youtube.com/thelancettv

In this month’s episode we discuss childhood-onset Sjögren’s disease-a rare and under-researched rheumatic condition.  Lack of robust clinical and immunological characterisation of this condition alongside assessment of its impact on quality of life has significantly hampered progress in the delivery of high-quality research and evidence-based recommendations for care.  There are currently no studies following up children and young people with childhood-onset Sjögren's disease as they move into adulthood and there remains a clear knowledge gap surrounding the natural course and long-term outcomes of childhood-onset Sjögren's disease. Professor Coziana Cuirtin from the Centre for Adolescent Rheumatology at the University College London discusses the long-term outcomes of patients with childhood-onset Sjögren’s disease. We also discuss barriers and facilitators to recruiting these patients, the current management strategies available and what’s next for childhood-onset Sjögren’s disease research. Click here to read the full article: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00283-8/fulltext ----------------------------------------------- Medical imaging and theranostics are revolutionising how we diagnose, treat, and understand disease. To meet this moment, The Lancet group is happy to announce the launch of, The Lancet Medical Imaging and Theranostics.  You can visit https://www.thelancet.com/medical-imaging-theranostics to learn more. Continue this conversation on social! Follow us today at... https://thelancet.bsky.social/ https://instagram.com/thelancetgroup https://facebook.com/thelancetmedicaljournal https://linkedIn.com/company/the-lancet https://youtube.com/thelancettv

This months episode covers Hemophagocytic lymphohistiocytosis, or HLH, a rare, life-threatening disorder characterised by dysregulated immune activity resulting in systemic inflammation, tissue damage and multiorgan failure which affects both children and adults. The annual prevalence of HLH in England is around 2 per million people in the adult population, with an overall 1-year survival rate of around 50% and similar rates have also been reported in other countries across the world. However, as most studies of HLH prevalence primarily focus on single nations and specific subpopulations, epidemiological data on global incidence and mortality rates are scarce. Dr Fiona Pearce and Dr Rachel Tattersall discuss their recent publication in The Lancet Rheumatology which looked at mortality rates of HLH across Europe, we also discuss what manifestations clinicians should be looking out for and what’s next for HLH research. Click here to read the full article: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00292-9/fulltext Continue this conversation on social! Follow us today at... https://thelancet.bsky.social/ https://instagram.com/thelancetgroup https://facebook.com/thelancetmedicaljournal https://linkedIn.com/company/the-lancet https://youtube.com/thelancettv

During this episode, Dr John Isaacs and Dr Josh Bennett from Newcastle University and the NIHR Newcastle Biomedical Research Centre, discuss sarcopenia - an age-related loss of muscle mass and strength. Sarcopenia is relatively common in rheumatoid arthritis, with a prevalence ranging from 4·5% to 44% of people with rheumatoid arthritis, depending on the definition of sarcopenia used. Rheumatoid sarcopenia increases the risk of fall, fractures, disability, and hospitalisation. Therefore, prevention and management is important, especially in older patients. We discuss the how and why sarcopenia arises and how it can be managed, as well as the recent publication of the RAMUS study, which looked at the skeletal muscle effects of JAK inhibitor tofacitinib in rheumatoid arthritis. The link to the Nature Rheumatology Review mentioned can also be found below. RAMUS study: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00184-5/fulltext Nature Rheumatology Review: https://www.nature.com/articles/s41584-023-00921-9 Continue this conversation on social! Follow us today at... https://thelancet.bsky.social/ https://instagram.com/thelancetgroup https://facebook.com/thelancetmedicaljournal https://linkedIn.com/company/the-lancet https://youtube.com/thelancettv

This month's episode covers Sjögren’s disease—an autoimmune condition that primarily affects areas of the body that produce fluids, such as tears and saliva. The cause of the disease isn’t understood. Currently there are no licensed drugs to treat the disease, but phase 2 clinical trials have reported encouraging results, and phase 3 trials are underway. Dr Samuel Bitoun, from the University of Paris-Saclay and APHP, discusses how Sjögren’s disease is currently classified, the challenges of using such classification, and how AI and deep learning could potentially contribute to this area, which is the focus of his recent study published in The Lancet Rheumatology, which aimed to train a neural network model to perform focus score classification and identify new histological patterns associated with this disease. Click here to read the full article: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00181-X/fulltext Continue this conversation on social! Follow us today at... https://thelancet.bsky.social/ https://instagram.com/thelancetgroup https://facebook.com/thelancetmedicaljournal https://linkedIn.com/company/the-lancet https://youtube.com/thelancettv

In today's episode, Sophie discusses psoriatic arthritis with Dr Ryan Hum from The University of Manchester. Psoriatic arthritis affects between 0.1% and 1% of the general population globally, and appears to be more prevalent in certain regions. It affects men and women equally and typically appears between the ages of 30 and 55 years. Psoriatic arthritis tends to be more common in people with psoriasis affecting around 20% of individuals, but estimates can depend on the inclusion criteria studies use. We touch on the pathogenesis of psoriatic arthritis and how it might manifest in a patient, as well as the contribution of synovial inflammation and how research into this topic contributes to our understanding of the disease. We also discuss the reasons psoriatic arthritis research is in the early stages when compared to rheumatoid arthritis.  The Review discussed can be found here: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00231-0/fulltext Continue this conversation on social! Follow us today at... https://thelancet.bsky.social/ https://instagram.com/thelancetgroup https://facebook.com/thelancetmedicaljournal https://linkedIn.com/company/the-lancet https://youtube.com/thelancettv