Rheum Advisor on Air

Messages and characters portrayed through film, television, and digital media have far-reaching effects and consequences on society. For many decades, the onscreen portrayal of gout has promoted inaccurate beliefs about its causes and management, such as self-indulgence and social status, as well as an association with humor, shame, and embarrassment. Subsequently, these misrepresentations have negatively affected the mental health and quality of life of patients with gout.

How can rheumatologists and providers address the issue?

This episode features Nehad Soloman, MD, a rheumatologist at Arizona Arthritis & Rheumatology Associates, and Christina Derksen, one of the study authors on a paper about the fictional depictions of gout in film and television, published in BMC Rheumatology.

Inflammatory syndromes often have overlapping clinical manifestations, making them difficult to diagnose and categorize. Using a genome-first approach, researchers at the National Institutes of Health (NIH) have discovered an inflammatory disease called vacuoles, E1 enzyme, X-linked, autoinflammatory and somatic syndrome (VEXAS) that is caused by mutations in the UBA1 gene.

In this episode, Peter Grayson, MD, MSc, a study author on the recent paper published in the New England Journal of Medicine, gives us further insight into the discovery of the VEXAS syndrome and the overall importance of rare rheumatic disease research at the genetic and molecular level.

Multisystem autoimmune rheumatic diseases are rare or ultra-rare disorders linked to significant mortality and morbidity. However, with the rise of new technology, including data registries and advanced genetic analysis, rare rheumatic disease research is being propelled forward to inform future therapeutic options and improve patient outcomes.

In light of Rare Disease Day 2021, Dr Jonathan Miner, MD, PhD, discusses his work and contributions to the rare disease space, and speaks to the importance of research and the management of patients with rare rheumatic diseases.

In the past year, coronavirus disease 2019 (COVID-19) has presented unique challenges to rheumatology practices and care. Although not at the frontline, rheumatologists have had to face difficult decisions regarding, and not limited to, immunosuppressant management and the continuity of care for patients. But with the COVID-19 vaccines at the helm, what does the current rheumatology landscape look like and what is potentially in store for the future of patient care?

In this episode, Amit Ladani, MD, a rheumatologist at West Virginia University Hospital, gives us his point-of-view.

Editor's Note: Please note that this episode was developed and edited before the American College of Rheumatology (ACR) released clinical guidance regarding COVID-19 vaccines in patients with rheumatic and musculoskeletal diseases. We will be providing updated information soon.

Pregnancy for patients with antiphospholipid syndrome (APS) and lupus has historically been associated with complications, including increased risk for preeclampsia, fetal growth restriction, and fetal death, but outcomes have improved in the last 2 decades. However, identifying, predicting, and preventing the risk for pregnancy complications in this population still remains challenging.

Taking us on a deep dive into the subject is the 2020 recipient of the Rheumatology Research Foundation Shaun Ruddy Memorial Lectureship, Jane Salmon, MD, the Collette Kean Research Chair at the Hospital for Special Surgery and professor of medicine and obstetrics and gynecology at Weill Cornell Medicine, New York.

There is a significant prevalence of mental health disorders among pediatric patients with rheumatic disease, increasing the risk for adverse outcomes not just in mental health, but also the underlying rheumatic condition. Pediatric rheumatologists, along with mental health professionals, are positioned to provide mental health screening and interventions for this patient population; however, it has been observed that there are significant gaps in the area of mental health in pediatric rheumatology.

Imaging is an important aspect in the diagnosis and monitoring of large vessel vasculitides, including Takayasu and giant cell arteritis. However, traditional imaging modalities have consistently posed setbacks in terms of diagnostic accuracy for these conditions.

Our featured guest on this episode Anisha Dua, MD, gives us a brief insight into the various challenges observed with large vessel vasculitis imaging, particularly temporal artery biopsy, and how the inclusion of certain modalities, including ultrasound and magnetic resonance imaging (MRI), may improve diagnosis in these patients and our understanding of large vessel vasculitis.

To facilitate high-quality patient care and to include new and emerging evidence, the American College of Rheumatology (ACR) has developed and updated the guidelines for the management of rheumatoid arthritis (RA).

Our featured guest on this episode is Stanley Cohen, MD, who gives us a glimpse into the scope and new updates to the ACR guidelines, which are currently in the draft stage.

Approved by the US Food and Drug Administration for the treatment of refractory gout, pegloticase, in combination with immunomodulatory agents, is an area of gout treatment that has shown much promise.

Our featured guest on this episode is Brian LaMoreaux, MD, MS, an investigator on many gout studies, who provides an overview of the notable research in pegloticase treatment in gout, as presented at the American College of Rheumatology (ACR) 2020 annual meeting.

There is growing evidence - both in animal models and humans - to suggest the significant role of the microbiome in the etiology of rheumatic diseases. Over the years, multiple microbial agents and changes in the composition of the microbiota have been associated with specific autoimmune diseases, only emphasizing the importance of the microbiome in rheumatology research today.

To give us further insight into this relevant topic, we are joined in this episode by Maximilian Konig, MD, of the Division of Rheumatology at the Johns Hopkins Hospital in Baltimore, Maryland, and Veena Taneja, PhD, associate professor of immunology in the Department of Immunology and Rheumatology at the Mayo Clinic in Rochester, Minnesota.