MRI Definition of OA

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! 

Knowing that glucocorticoids significantly increase the risk of fractures and is the most common cause of secondary osteoporosis, the use of the steroid has always been viewed as a doubled edged sword and “Bad for the Bones”. This week, we welcome Dr. Giovanni Adami, first author of Bone Loss in Inflammatory Rheumatic Musculoskeletal Disease Patients Treated with Low-Dose Glucocorticoids and Prevention by Anti-Osteoporosis Medications , whose goal for this study was to assess if a “safe” dose of glucocorticoids exists, with an attention focus on those with inflammatory rheumatic musculoskeletal diseases (iRMDs) to determine if a low enough dose of glucocorticoids can still reduce inflammatory burden and yet significantly reduce expected risk of fracture. 

The pandemic has changed much in our world—from the way we work, to the way we shop, and even the way we learn. Rheumatology wasn’t immune from such changes and when medical institutions needed to adjust their practices to accommodate a changing world around them, the process by which fellowship interviews were conducted needed to change as well. Thus, a shift to the video communication platform Zoom was made.

Now, as the pioneering cohorts of the new Zoom matching process graduate, we are joined by Bharat Kumar, MD, MME, FACP, RhMSUS. Dr. Kumar has been doing a lot of research on what went well, what didn’t, and what merits rethinking. Dr. Kumar is the first author of the manuscript Reimagining the Rheumatology Fellowship Interview: Using Participatory Design-Thinking Process to Create a More Applicant-Centered Experience.

Our next guest, Dr. Paul Monach, reviews “Complement”, focusing on its application in the clinical setting. In his work, Dr. Monach presents a typical case with a broad differential diagnosis, then provides an overview of the complement system along with clinical diseases with complement-driven mechanisms. Dr. Shanmugam reviews this manuscript published in Arthritis & Rheumatology plus an analysis of the laboratory tests. Later in the show, Dr. Monach gives us his insights on how he combines his clinical work with his translational work in immunology and acts Chief of Immunology at the VA in Boston, Massachusetts! 

End-stage renal disease is a dangerous reality for those who suffer from Lupus Nephritis (LN), despite improvements in immunosuppressive therapy in the last 20 years. Our next guest, Dr. Brad H Rovin, MD, FACP, FASN, is the first author of the manuscript “Kidney-Related Outcomes and Steroid-Sparing Effects in Patients with Active Lupus Nephritis Treated with Obinutuzumab: A Post Hoc Analysis of a Phase 2 Trial.” which was recently published in Arthritis & Rheumatology. This study was a post hoc analysis of the NOBILITY trial and was conducted to assess kidney-related outcomes in patients using Obinutuzumab. 

This week on ‘Journals’, we turn our attention to a rare but challenging and heart-breaking complication of rheumatic disease, Congenital Heart Block. Sir Deryck and Lady Va Maughan Professor of Rheumatology and Director of the Division of Rheumatology at New York University School of Medicine, Dr. Jill Buyon joins us today to present her latest research “Prospective Evaluation of Anti-SSA/Ro Pregnancies Supports the Utility of High Titer Antibodies and Fetal Home Monitoring for the Detection of Fetal Atrioventricular Block.”. 

This week we welcome our next guest, Dr. John D. Pauling to ‘Journals’. Dr. Pauling is the senior author of the manuscript “Assessment of the Systemic Sclerosis-Associated Raynaud’s Phenomenon Questionnaire: Item Bank and Short Form Development”, which endeavored to “develop, refine and score a novel patient-reported outcome instrument to assess the severity and impact of Raynaud’s Phenomenon (RP) in Systemic Sclerosis (SSc)”. In this episode, we discuss the challenges associated with measuring one of the most common disease manifestations of scleroderma, Raynaud’s, and how the Assessment of Systemic Sclerosis-Associated Raynaud’s Phenomenon (ASRAP) questionnaire was harmonious in the paper’s results and final conclusions.