History Matters

When disease strikes, time becomes a critical resource our patients cannot afford to waste. For those with axial spondyloarthritis (axSpA), an inordinate amount of time often goes by before a proper diagnosis is made, resulting in delays for crucial treatments to be rendered. The reasons for this delay in diagnosis, particularly among those with axSpA are diverse, complicated and not well-understood. Our guest, Dr. Gregory McDermott, attempted to better understand this diagnostic delay with his study: Factors Associated With Diagnostic Delay in Axial Spondyloarthritis: Impact of Clinical Factors and Social Vulnerability  in hopes that we may begin answering these challenges with solutions.  

Systemic Sclerosis (SSc) is a painful and debilitating disease that our patients suffer from. However, a newly published study has concluded that there are some self-management interventions patients can engage with that have shown to improve fatigue, particularly for those newly diagnosed with SSc. Today, we review the procedures, interventions, results and conclusions of this study, titled: Effects of a Resilience-Building Energy Management Program on Fatigue and Other Symptoms in Systemic Sclerosis: A Randomized Controlled Trial, along with two of its authors, Dr. Susan L Murphy and Ms. Mary Alore, and how your patients can benefit from its lessons. 

As the need and demand for quality care increases, time in clinic needs to become more efficient. Working smarter, not harder, is a daily challenge for all in our field. With mobile technology streamlining so much and improvements in patient reported outcome (PRO) collection among patients with rheumatoid arthritis (RA) needed, it had Dr. Daniel Solomon asking “...is there an app for that?”. Today, we review the study A Mobile Health Application Integrated in the Electronic Health Record for Rheumatoid Arthritis Patient–Reported Outcomes: A Controlled Interrupted Time-Series Analysis of Impact on Visit Efficiency , recently published in Arthritis & Rheumatology. Our guest, Dr. Daniel Solomon, is our guest and the study’s first author. 

Recent research indicates that those who suffer from AxSpA may have some hope in protecting against events of Uveitis! Dr. Katie Bechman, first author Incidence of Uveitis in Patients With Axial Spondylarthritis Treated With Biologics or Targeted Synthetics: A Systematic Review and Network Meta-Analysis, explains her team’s research findings and how they came to this exciting conclusion! 

“If I have seen further, it is because I stand on the shoulders of giants” Sir Isaac Newton famously stated in a letter to polymath scientist, Robert Hooke back in 1675. Today, Dr. Mary Crow, MD, aides Arthritis & Rheumatology launch a series on immunology, for rheumatologists. She is the co-author of the article Standing on Shoulders: Interferon Research, from Viral Interference to Lupus Pathogenesis and Treatment. In this episode, we stand with Dr. Crow to look back at the achievements made by brilliant minds in interferon research and analyze the unbroken line their advancements in rheumatology have led to today’s discoveries, with more to com

Is there an increased risk of cancer once a patient has Scleroderma? If so, what is the risk and how does one go about showing this? Dr. Ami A Shah, Director of the Division of Rheumatology at Johns Hopkins sits down with us to explain those answers. We go over the methods, results and conclusions of the recent study Distinct Scleroderma Autoantibody Profiles Stratify Patients for Cancer Risk at Scleroderma Onset and During the Disease Course published in Arthritis & Rheumatology. Afterward, Dr. Shah shares with us her journey to becoming a physician-scientist and mentoring others in Scleroderma research through a K24 grant. 

Welcome back to “Journals”! Our topic of discussion today comes from the manuscript Anti-Gephyrin Antibodies: A Novel Specificity in Patients With Systemic Sclerosis and Lower Bowel Dysfunction and our guest today is the study’s first author, Dr. Zsuzsanna McMahan. The study recognizes that the enteric nervous system (ENS) regulates the gastrointestinal (GI) function, which is commonly impaired in those who suffer from systemic sclerosis (SSc). Dr. McMahan and her team’s objective for this study was “to identify novel anti-ENS autoantibodies with an aim to clinically phenotype SSc GI dysfunction”. We sit down with Dr. McMahan and discuss the study’s methods and discoveries. Plus, her experience transitioning from a junior to an independent investigator and what advice she can offer our young listeners for the journey along the way. 

Dr. Tobit Steinmetz is our guest this week, author of the manuscript recently published in “Arthritis and Rheumatology” titled: "Association of Circulating Antibody-Secreting Cell Maturity with Disease Features in Primary Sjogren's Syndrome." Dr. Steinmetz and his team endeavored to better understand the hyperactivity observed among B cells, which play a major role in Primary Sjogren’s Syndrome (SS). To do this, he and the team examined the quantity, maturity and inflammatory properties of Antibody Secreting Cells (ASCs) in the B cell effector branch, which became the focus of the study. Tune in to hear how this was done, what their observations and conclusions were plus, Dr. Steinmetz’s insights for those looking to enter a postdoctoral position! 

After a major event, it’s important to take stock of the causes of such an event, but just as important, on the reactions to it. No other event has challenged humanity in recent memory like COVID-19. Today we discuss the pandemic in relationship to its impact on those who suffer with rheumatic disease and examine the global response. Our guest is Dr. Evelyn Hsieh, MD, PhD, the first author of the paper: Global Perspective on the Impact of the COVID-19 Pandemic on Rheumatology and Health Equity , which was recently published in Arthritis Care & Research. 

Sometimes, we learn more from what isn’t achieved than when we achieve an expected result. Such is the case for our next guest, Dr. David R. Jayne, who is the first author of Clinical and Biomarker Responses to BI 655064, an Antagonistic Anti-CD40 Antibody, in Patients With Active Lupus Nephritis: A Randomized, Double-Blind, Placebo-Controlled, Phase II Trial , a study designed to characterize a dose-response relationship between an anti-CD40 monoclonal antibody known as Bi 655064 and complete renal response (CRR) in patients with active lupus nephritis (LN). Dr. Jayne and his research team’s study may not have shown this dose-response relationship, but what was gained along the way surely shows the power of the negative study!