PAs In Rheumatology: A Joint Effort

In this episode of ACR Journals on Air, host Dr. Vicki Shanmugam returns to the mic and dives into the CLASS Project—an ambitious international study on anti-synthetase syndrome recently published in Arthritis & Rheumatology. Joined by Drs. Sara Faghihi-Kashani, Akira Yoshida, and Giovanni Zanframundo, she explores the clinical characteristics, antibody profiles, and skin and lung manifestations of this complex autoimmune condition. The conversation covers everything from global collaboration challenges to nuanced antibody testing and rare clinical features like hikers’ feet. With insightful perspectives from each guest, this episode sheds light on the evolving understanding of anti-synthetase syndrome and the future directions of the CLASS initiative. 

With the growing shortage of rheumatology specialists in the U.S., healthcare systems face increasing delays, clinician burnout, and inefficiencies. In this episode, we explore a promising solution: the integration of physician assistants/associates (PAs) into rheumatology practice. We’re joined by Benjamin Smith, PA-C, Associate Dean and Program Director at Florida State University, and first author of "Profile and Attributes of Physician Assistants/Associates in Rheumatology" published in Arthritis Care & Research. He shares insights into the demographics, workload, satisfaction, and future potential of rheumatology PAs, highlighting their expanding role in addressing workforce gaps and enhancing patient care. 

Dr. Laura Plantinga joins us to discuss her recent work on the APPEAL study, which examines how lupus affects activities of daily living using patient-reported outcomes and validated measures such as IADLs, BADLs, SLAQ, and PROMIS. We explore her methodological approach, key findings, and implications for clinical practice—particularly how physicians can better support patients in managing functional limitations. Dr. Plantinga also shares insights on translating epidemiologic data into actionable strategies and maintaining scholarly productivity in academic medicine. 

In this episode, we explore a new approach to improving participation in lupus clinical trials by strengthening provider outreach and education. Our guest, Dr. Saira Sheikh of UNC Chapel Hill, discusses the TIMELY study, which focuses on involving healthcare providers and community health workers to better connect patients with trial opportunities. From roundtable discussions to changes in provider behavior, we highlight practical strategies that could improve how clinical trials are conducted. 

In this episode, Dr. Kaur and Dr. Abhishek join us to discuss their recent study on acetaminophen, exploring how it compares to NSAIDs in safety and effectiveness. They break down their use of the Clinical Practice Research Datalink (CPRD), key findings—especially in arthritis patients—and what this means for clinical practice. It's an insightful look at how big data can challenge assumptions about one of the most used pain medications. 

On this episode, we chat with Dr. Sho Fukui about his recent study on rising uric acid levels and what’s driving the increase. We dig into the links between weight, obesity, and gout, and hear how a huge health checkup database in Japan helped uncover some eye-opening trends. Dr. Fukui breaks down the findings in simple terms, shares how they compare to older studies like MRFIT, and talks about what they could mean for treatments like GLP-1s. Plus, we get a sneak peek at the exciting research he’s working on next! 

In this episode, we’re joined by Dr. Atul Deodhar, a leading expert in the field of Axial Spondyloarthritis (AxSpA). Dr. Deodhar shares insights from his groundbreaking research on the pathophysiology, diagnosis, and management of AxSpA, particularly focusing on the efficacy and safety of IV secukinumab. We dive deep into his study, INVIGORATE-1, exploring the methods behind it, including the use of Interactive Response Technology, and the primary and secondary endpoints that shed light on this treatment’s impact. We also discuss the latest data on patient preferences for subcutaneous versus intravenous immunomodulators and the implications of these findings. Tune in for an informative and engaging conversation that blends cutting-edge science with thoughtful reflections on patient care. 

This week, we explore the genetics behind the production of antinuclear antibodies (ANA) in individuals without clinical autoimmune disease, using data from the All of Us registry. Our guest, Dr. Mehmet Hocaoglu shares insights into the significance of understanding ANA positivity and its potential genetic underpinnings, highlighting how large-scale genome-wide association studies (GWAS) can predict susceptibility to autoimmune conditions. We cover the study's methodology, the unique All of Us dataset, and the complexities of genetic analysis. Dr. Hocaoglu also discusses his personal journey in rheumatology research, offering advice for aspiring researchers, especially international medical graduates (IMGs).  

In this episode, our host is joined by Dr. Peter Nigrovic, an expert in Macrophage Activation Syndrome (MAS). Dr. Nigrovic, delves into the complexities of MAS. The discussion covers the syndrome's history, diagnostic challenges, mechanisms of inflammation, and the latest treatment strategies, including cytokine blockade, JAK inhibitors, and chemotherapy options. Dr. Nigrovic also reflects on his unique career journey, offering valuable insights into combining clinical practice and research, while sharing his philosophy for a fulfilling life in medicine and science. This episode is a thorough exploration of MAS and provides practical advice for clinicians dealing with this complex syndrome. Macrophage Activation Syndrome 

In this episode we explore the role of Neutrophil Extracellular Traps (NETs) in systemic lupus erythematosus (SLE). Dr. Mariana Kaplan, Chief of the Systemic Autoimmunity Branch at the National Institute of Arthritis Musculoskeletal and Skin Diseases, joins the discussion to break down the complex immunological mechanisms driving lupus, focusing on the contribution of NETs and Low-Density Granulocytes (LDGs) to disease activity and tissue damage. The conversation delves into the potential for these biological markers to improve diagnosis and treatment strategies, particularly in the context of lupus flares and cardiovascular complications. A link to this week’s article can be found, here: Exploring the Role of Neutrophil Extracellular Traps in Systemic Lupus Erythematosus: A Clinical Case Study and Comprehensive Review