Rheumatology

03 Aug

Posted at 14:40h in Pain Research, Rheumatology

That familiar, deep ache in your knee has returned. The relief from your last cortisone shot wore off faster this time, and the physical therapy exercises, while helpful, can't stop the grinding pain that limits your daily life. You might feel caught in a frustrating cycle, believing your only options are temporary fixes or a major joint replacement operation down the road.

This cycle can feel like a dead end. But the landscape for treating knee osteoarthritis pain is expanding. New approaches are focusing on the underlying inflammation that drives the pain, rather than just masking symptoms or replacing the joint entirely. Understanding these options is key to finding a path forward that aligns with your goals for activity and quality of life. For a broader overview of the minimally invasive approaches now bridging the gap between conservative care and surgery, see this overview of managing joint pain without surgery.

Quick answer: For moderate to severe knee osteoarthritis, newer minimally invasive procedures can target the specific inflammation causing your pain. This offers a potential middle ground between temporary injections and total knee replacement surgery, often with a much shorter recovery period.

What's inside:

  • Why Standard Knee OA Treatments Sometimes Fall Short
  • Understanding Inflammation's Role in Chronic Pain
  • What is Genicular Artery Embolization (GAE)?
  • Comparing GAE to Knee Replacement Surgery
  • Who is a Candidate for a Minimally Invasive Approach?
  • Critical Questions to Ask Your Doctor Before Deciding
[caption id="attachment_75387" align="aligncenter" width="500"]got-knee-pain-pexels.jpg Photo by Towfiqu barbhuiya:[/caption]

18 Apr

Posted at 17:27h in Author Interviews, PT-Rehabilitation, Rheumatology
[caption id="attachment_73342" align="aligncenter" width="500"]knee-compression-osteoarthritis.jpg Photo by Terry Shultz P.T. on Unsplash[/caption] Symptomatic knee osteoarthritis affects roughly 13.8 percent of adults over 40, making it one of the most common causes of chronic joint pain worldwide. As clinicians increasingly prioritize conservative management over early pharmacological intervention, non-pharmacological strategies have gained renewed attention. Among these, compression bracing has emerged as a subject of growing research interest, with recent meta-analyses suggesting measurable benefits for pain, stiffness, and physical function. A body of evidence now supports the idea that compression knee support shown to improve joint proprioception through stimulation of cutaneous mechanoreceptors surrounding the joint capsule. This mechanism, first described in biomechanical research published in the Journal of Sports Science & Medicine (PubMed 15388537), offers a physiological rationale for what many patients report anecdotally: that wearing a compression sleeve makes the knee feel more stable during movement. For clinicians weighing treatment options, the question is no longer whether bracing has a role in osteoarthritis care, but which type of brace matches a given patient's needs.

13 Feb

Posted at 13:50h in Autoimmune Diseases, Immunotherapy, Personalized Medicine, Rheumatology
[caption id="attachment_72398" align="aligncenter" width="500"]Personalized Medicine for Addressing Autoimmune Disorders Pexels[/caption]
Innovative approaches to tailored healthcare are revolutionizing the diagnosis and treatment of autoimmune disorders. Rather than relying on uniform treatment strategies, clinicians now tailor therapies to each patient’s unique biological profile. Genetic makeup, immune system behavior, and lifestyle factors all influence disease expression and response to care.  This approach is especially important for conditions like rheumatoid arthritis, lupus, and multiple sclerosis, where variability is significant. Integrating genomics and biomarker analysis improves diagnostic accuracy and treatment selection. Together, these innovations enable more precise interventions, better outcomes, and fewer adverse effects for patients. In this article, we will explore innovations shaping highly targeted, patient-centered autoimmune care.

Understanding Autoimmune Disease Heterogeneity

Autoimmune disorders show significant diversity across diseases and among patients with the same diagnosis. Differences in genetics, immune responses, environmental exposures, and progression patterns drive this variability. Even individuals with rheumatoid arthritis may experience distinct symptoms and treatment outcomes. Understanding these differences is vital for designing truly individualized therapies. A study published in Scientific Reports estimates that autoimmune diseases affect approximately 7% of the global population. These conditions are typically classified by the specific organ or system involved. This approach has identified more than 100 clinically distinct autoimmune disorders, underscoring significant disease heterogeneity. 

30 Jan

Posted at 12:17h in Pain Research, PT-Rehabilitation, Rheumatology

Combining mind-body techniques with other osteoarthritis treatments is generally safe, but it’s important to consult with healthcare providers. Some techniques, like intense physical exercises or stress reduction methods, could interact with medications or therapies. A tailored, supervised approach ensures safety and prevents potential complications or overexertion....

10 Dec

Posted at 10:21h in Exercise - Fitness, Rheumatology
  [caption id="attachment_65397" align="aligncenter" width="500"]arthritis-exercise-golf Photo by Steve Momot[/caption] Arthritis is a common condition that can cause pain, stiffness, and swelling in the joints, affecting mobility and quality of life. Engaging in regular physical activity is one of the effective ways to manage and potentially prevent the onset of arthritis. Including specific activities in your routine can improve joint health and reduce the risk of developing arthritis. Exercise not only strengthens the muscles around the joints but also promotes flexibility and balance, which are critical factors in minimizing arthritis symptoms. This article explores a variety of physical activities that can be beneficial for joint health, offering an accessible approach to arthritis prevention for individuals of all fitness levels.

23 Oct

Posted at 09:16h in Orthopedics, Rheumatology
[caption id="attachment_64210" align="aligncenter" width="282"]ankle-arthritis Source[/caption] Ankle arthritis might be less common than arthritis in the knee or hip, but it can be no less debilitating. It occurs when the cartilage in your ankle joint wears down, leading to pain, swelling, and stiffness. When you think about it, each step you take involves your ankle bearing considerable weight. If you have ankle arthritis, this will make even routine everyday activities like walking more difficult to manage. Thankfully, there are various treatment options available to manage symptoms and improve quality of life. These include seeing a foot and ankle orthopedic surgeon to discuss your options, and some surgical or medicinal options to consider, depending on the severity of your situation. Here is a look at the causes, symptoms, and different treatment approaches available, and suggestions on when it might be necessary to see a foot and ankle orthopedic surgeon.

22 Jun

Posted at 22:30h in Abuse and Neglect, Gout, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_62055" align="alignleft" width="200"]Brian LaMoreaux, MD, MSInternist and Rheumatologist Executive Medical Director, Amgen Dr. LaMoreaux[/caption] Brian LaMoreaux, MD, MS Internist and Rheumatologist Executive Medical Director, Amgen MedicalResearch.com: What is the background for this study? How does KRYSTEXXA® (pegloticase) work in gout? Response: Many other diseases in gout have well-defined definitions of remission, but gout has lagged behind on this. With systemic consequences of gout becoming more apparent, the concept of treating gout to remission is increasing important to improving patient care and preserving patient health.   Our MIRROR randomized controlled trial (RCT) provides data beyond the primary and secondary endpoints and allows us to look at aspects like the rate of gout remission (i.e. serum urate level (SU) <6 mg/dL, absence of acute gout flare, absence of tophi, minimal gout-related pain, and minimal gout-related quality-of-life impact over a 12-month period) achieved with KRYSTEXXA-induced intensive urate-lowering. Continuing to advance knowledge that can positively impact patient care is our driving force for the research. KRYSTEXXA is approved for the treatment of uncontrolled gout, for those experiencing signs and symptoms of gout despite taking oral medicines. It is the only gout treatment that controls uncontrolled gout by changing uric acid into a water-soluble substance called allantoin that he body easily gets rid of through urine.

28 Mar

Posted at 14:11h in Author Interviews, Dermatology, Genetic Research, Nature, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_61503" align="alignleft" width="150"]Chelisa Cardinez PhDPostdoctoral Researcher The Burr Laboratory- Cancer Immunology and Epigenetics Genome Sciences and Cancer Division The John Curtin School of Medical Research The Australian National University Canberra, Australia Dr. Cardinez[/caption] Chelisa Cardinez PhD Postdoctoral Researcher The Burr Laboratory- Cancer Immunology and Epigenetics Genome Sciences and Cancer Division The John Curtin School of Medical Research The Australian National University Canberra, Australia   MedicalResearch.com: What is the background for this study? Response: Psoriasis is a skin inflammatory disease that affects approximately 2-3% of the population. Previous research had identified that the cytokine IL-17 drives the development of this disease. However, key questions that remained unknown about psoriasis included where did the IL-17 come from, and why do some patients with psoriasis also go on to develop systemic inflammatory conditions such as arthritis. Our research aimed to address these questions using a gain of function (GoF) mouse model that carried a genetic variant in a gene called IKBKB.

08 Feb

Posted at 13:22h in Author Interviews, Inflammation, Kidney Disease, Nature, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_61322" align="alignleft" width="150"]A/Prof. Joshua Ooi, PhDHead, Regulatory T-cell Therapies Translational Research Facility Clinical Sciences at Monash Health, Monash University Dr. Ooi[/caption] A/Prof. Joshua Ooi, PhD Head, Regulatory T-cell Therapies Translational Research Facility Clinical Sciences at Monash Health, Monash University MedicalResearch.com: What is the background for this study? Response: In 2017, we published a landmark Nature paper showing that people who are protected from autoimmune disease have specialized molecules on immune cells. These specific molecules are missing in patients that develop autoimmune disease.

06 Jun

Posted at 18:33h in Author Interviews, Columbia, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_60486" align="alignleft" width="150"]W. Benjamin Nowell Dr. Nowell[/caption] W. Benjamin Nowell PhD Director of Patient-Centered Research at Global Healthy Living Foundation Columbia University in the City of New York New York, New York MedicalResearch.com: What is the background for this study? Response: Given that lab tests are an important part of rheumatoid arthritis (RA) diagnosis and monitoring, people living with the condition want and need to understand their lab results –also known as blood work – for patient-centered shared decision making about treatment. The presentation titled, “Patient Perceptions of Rheumatoid Arthritis Blood Work and Utility of a Test Predicting Response to New Medication: A Cross-sectional Survey in the ArthritisPower,” presented at the 76th EULAR European Congress of Rheumatology (June 2, 2023 in Milan, Italy) includes results from a recent ArthritisPower survey (n=405) that asked patients to share their perceptions about RA bloodwork, reasons their doctor orders these tests, and how results are used.

29 Mar

Posted at 01:54h in Author Interviews, Immunotherapy, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_60246" align="alignleft" width="150"]Siri Lillegraven MD MPH PhDVice director, REMEDY Center for treatment of Rheumatic and Musculoskeletal Diseases Leader, Unit for Clinical Research, Diakonhjemmet Hospital Associate professor, Institute of Health and Society, Faculty of Medicine University of Oslo Dr. Lillegraven[/caption] Siri Lillegraven MD MPH PhDVice director, REMEDY Center for treatment of Rheumatic and Musculoskeletal Diseases Leader, Unit for Clinical Research, Diakonhjemmet HospitalAssociate professor, Institute of Health and Society, Faculty of Medicine University of Oslo   MedicalResearch.com: What is the background for this study? Response: Rheumatoid arthritis, or RA, is a chronic disease, with joint inflammation as the primary manifestation. Due to advances in RA therapy and care, an increasing number of patients achieve sustained remission without joint damage progression and functional loss. For these patients, dose-reduction of disease modifying anti-rheumatic drugs (DMARDs), or complete withdrawal of therapy could be favorable due to potential reductions in adverse events, burden of taking medication, and healthcare costs. Current treatment recommendations suggest that tapering of conventional synthetic DMARDs could be considered in patients in sustained remission, but there is a lack of data to guide treatment decisions.

26 Feb

Posted at 11:49h in Author Interviews, Dermatology, JAMA, Pediatrics, Rheumatology

MedicalResearch.com Interview with: Siri Choragudi Medical Student University of Miami Gil Yosipovitch, MD Professor and Stiefel endowed Chair of Medical Dermatology at the Dr Phillip Frost Department of Dermatology Miller School of Medicine at University of Miami [caption id="attachment_60062" align="alignleft" width="125"] Example of Eczema-Atopic DermatitisDermNet NZ Image[/caption] MedicalResearch.com: What is the background for this study? Would you briefly...

01 Dec

Posted at 14:57h in Author Interviews, Cost of Health Care, Rheumatology, University of Pittsburgh
MedicalResearch.com Interview with: Raisa Silva, M.D. Resident physician in Internal medicine University of Pittsburgh Medical Center MedicalResearch.com: What is the background for this study? Response: Systemic lupus erythematosus (lupus for short) is a complex disease that significantly affects patients’ lives. Adherence to medications for lupus is known to be suboptimal (it can be as low as 15% in some studies). Multiple social factors may affect treatment adherence. For example, costs of medications (including copayments, deductibles, co-sharing), polypharmacy (patients with lupus often have comorbid diseases that also need medications), and potential side effects are some of the reasons why patients may have difficulty in taking medications for lupus every day. The costs of insurance copayment may represent a major obstacle to adherence. The lack of adherence to lupus medications is associated with poor control of disease, more symptoms, and worse disease outcomes, such as more hospitalizations and more severe disease. In our study, we examined the association between lupus medications copayment and adherence to these medications (some of the most commonly used medications for lupus).

04 Nov

Posted at 20:21h in Author Interviews, COVID -19 Coronavirus, PLoS, Rheumatology
MedicalResearch.com Interview with: Professor Tim Vyse Professor of Molecular Medicine and Dr David Morris Non Clinical Lecturer in Molecular Genetics Guy’s Hospital, London MedicalResearch.com: What is the background for this study? What are the main findings? Response: We observed a correlation between the genetic associations with severe COVID-19 and those with systemic lupus erythematosus (SLE, Lupus), and aimed to discover which genetic loci were shared by these diseases and what biological processes were involved. This resulted in the discovery of several genetic loci, some of which had alleles that were risk for both diseases and some of which were risk for severe COVID-19 yet protective for SLE. The locus with most evidence of shared association (TYK2) is involved in interferon production, a process that is important in response to viral infection and known to be dysregulated in SLE patients.  Other shared associated loci contained genes also involved in the defense response and the immune system signaling. These results add to the growing evidence that there are alleles in the human genome that provide protection against viral infection yet are risk for autoimmune disease.

15 Sep

Posted at 23:31h in Author Interviews, Biogen, NEJM, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_59551" align="alignleft" width="150"]Nathalie Franchimont, M.D., Ph.D. Senior Vice President, Head of Multiple Sclerosis and Immunology Head of the Multiple Sclerosis and Immunology Development Unit Biogen Dr. Franchimont[/caption] Nathalie Franchimont, M.D., Ph.D. Senior Vice President, Head of Multiple Sclerosis and Immunology Head of the Multiple Sclerosis and Immunology Development Unit Biogen MedicalResearch.com: What is the background for this study? What are the main findings? Response: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organ systems. Rash and arthritis are among the most frequent manifestations of the disease and severe organ damage can also occur especially when organs like the kidney are affected. Litifilimab (known as BIIB059) is a monoclonal antibody being studied for the potential treatment of SLE and cutaneous lupus erythematosus (CLE). The Phase 2 LILAC study evaluated litifilimab versus placebo in two parts: Part A in participants who have SLE with active joint and skin manifestations; and Part B in participants with active CLE, including chronic and subacute subtypes, with or without other organ involvement. Results from the SLE portion of the study (Part A) show litifilimab met the study’s primary endpoint by significantly reducing total active joint count compared to placebo. Total active joint count was defined as the total number of tender or swollen joints. Litifilimab was generally well tolerated, with most reported adverse events (AEs) rated as mild or moderate. Note, this Phase 2 trial was not powered to assess secondary endpoints. Based on these positive Phase 2 results, Biogen is currently enrolling participants into the Phase 3 TOPAZ-1 and TOPAZ-2 studies, which will evaluate the efficacy and safety of litifilimab in participants with active SLE worldwide. Part B results from LILAC were published separately in NEJM on July 28, 2022 and expand the body of evidence supporting litifilimab as a potential first-in-class therapy for cutaneous lupus erythematosus in addition to SLE.

15 Jun

Posted at 19:57h in Author Interviews, Bristol Myers Squibb, Emory, Race/Ethnic Diversity, Rheumatology, UT Southwestern

Lupus is a rare chronic, hard-to-diagnosis autoimmune disease which disproportionately impacts women of color, particularly Black women, and the implicit and explicit bias within the health care system may prevent them from receiving a timely diagnosis and the best care possible....

07 Jun

Posted at 16:50h in Author Interviews, COVID -19 Coronavirus, Mental Health Research, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_59224" align="alignleft" width="150"]Kelly Gavigan, MPH Director, Data Management and Analytics Global Healthy Living Foundation Kelly Gavigan[/caption] Kelly Gavigan, MPH Director, Data Management and Analytics Global Healthy Living Foundation MedicalResearch.com:  What is the background for this study?  Response: COVID-19 is of particular concern for people living with autoimmune and rheumatic disease, not only because they have an increased risk of infection but also because of the heightened sense of isolation due to strict social distancing protocols that many patients continue to follow through today. As a result, we wanted to better understand if symptoms among the autoimmune and rheumatic disease patients in our ArthritisPower research registry were impacted throughout the COVID-19 pandemic. We previously conducted and reported on an analysis of patient reported outcome data from the ArthritisPower registry between the months of January 2020 to April 2021 at the American College of Rheumatology Convergence in 2021. We conducted a follow-up analysis between May and December 2021, which is our area of focus in this particular abstract.

24 Jan

Posted at 13:23h in Author Interviews, Kidney Disease, Rheumatology
[caption id="attachment_58695" align="alignleft" width="150"]Stephen Connelly, PhD, Chief Scientific Officer, Equillium Dr. Connelly[/caption] Stephen Connelly, PhD Co-founder & Chief Scientific Officer Equillium, Inc. San Diego, California MedicalResearch.com:  What is the background for this study?    Response: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease that predominantly affects women in the reproductive age range. Approximately 50% of SLE patients experience lupus nephritis (LN), a serious complication that is accompanied by significant morbidity and mortality. Progression of LN to chronic kidney disease is common, with 10% of patients with LN developing end-stage kidney disease. T cells, play a central role in the pathogenesis of both SLE and LN by mediating tissue damage and enhancing the production of autoantibodies by promoting B cell differentiation, proliferation, and maturation. These T cells express CD6, a costimulatory receptor that through its binding to activated leukocyte cell adhesion molecule (ALCAM), expressed on immune cells and tissues, modulates both the activity and trafficking of effector T cells (Teff). The expression of both CD6 and ALCAM (CD6-ALCAM pathway) have been associated with pathogenic effector T cell activity and trafficking in multiple autoimmune and inflammatory diseases. Based on a comprehensive screen of more than 1100 urine proteins, soluble urinary ALCAM (uALCAM) was identified as one of only a few molecules that were elevated in the urine of patients with SLE with active renal involvement compared with patients with quiescent or no prior nephritis. However, no studies had been conducted to characterize the cellular sources of the soluble ALCAM and questions remained about the relevance of this protein and whether it was associated with the pathology of the disease.

10 Nov

Posted at 13:17h in Author Interviews, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_52102" align="alignleft" width="200"]Kelly Gavigan, MPH Manager, Research and Data Science CreakyJoints  Kelly Gavigan[/caption] Kelly Gavigan, MPH Manager, Research and Data Science CreakyJoints and Global Healthy Living Foundation MedicalResearch.com: What is the background for this study? Response: We understood that COVID-19 is of particular concern for people living with autoimmune and rheumatic disease because they are at increased risk of infection, and this created a heightened sense of isolation due to the strict social distancing protocols that so many patients have followed. As a result, we wanted to better understand if symptoms among the autoimmune and rheumatic disease patients in our ArthritisPower research registry were impacted throughout the COVID-19 pandemic. We analyzed patient reported outcome scores for mental, social, and physical health measures between the months of January 2020 and April 2021. We tested the null hypothesis that there was no change in monthly average assessment scores across the 15-month observation period.

10 Nov

Posted at 01:00h in Author Interviews, COVID -19 Coronavirus, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_58359" align="alignleft" width="200"]Courtney K. Wells, PhD, MSW, MPH, LGSW Assistant Professor & Field Coordinator Department of Social Work University of Wisconsin-River Falls and member of CreakyJoints Dr. Wells[/caption] Courtney K. Wells, PhD, MSW, MPH, LGSW Assistant Professor & Field Coordinator Department of Social Work University of Wisconsin-River Falls and member of CreakyJoints MedicalResearch.com: What is the background for this study? Response: This study was initiated because early in the pandemic there was little information available regarding quality of life and the day-to-day activities of patients with rheumatic conditions. We were particularly interested in patients’ psychosocial experiences and how they made decisions about their health. We found that participants’ understanding of their risk for COVID-19 played a key role in their decision making processes. At the beginning of the pandemic, many participants viewed themselves as being high risk because of their condition and/or medications and took extreme precautions. These precautions isolated them from their family, friends, and healthcare, all of which negatively affected their physical and mental health. As the pandemic went on, participants described an exhausting balancing act between their risk for COVID-19, their rheumatic condition, and their mental health. Because we did interviews over 6 months, we saw participants shifting their priorities towards their mental health as more information became available and the vaccine emerged. We also learned that rheumatology patients from BIPOC ( Black, Indigenous, People of Color) and immigrant communities experienced unique stressors during the pandemic such as barriers to accessible and trusted healthcare providers and increased experiences of racism.

09 Jun

Posted at 00:32h in Author Interviews, Gout, Orthopedics, Rheumatology
MedicalResearch.com Interview with: Dr. Prof. Dr.  Gurkirpal Singh, MD Adjunct Clinical Professor of Medicine Stanford University MedicalResearch.com: What is the background for this study? Response: Joint damage from gout has been linked to a possible increase in knee and hip joint replacements. The strong association between gout and osteoarthritis could also lead to an increased risk of joint replacements in patients with gout as the presence of gout may accelerate or worsen osteoarthritis.[i] This study aimed to evaluate total or partial hip and knee joint replacements in patients with gout in the U.S. and to estimate their economic impact. Data was analyzed on hospitalizations in patients with gout with hip and knee joint replacements in 2018, using the Nationwide Inpatient Sample  (NIS) which is the largest publicly available all-payer inpatient healthcare database.

03 Feb

Posted at 12:57h in Author Interviews, BMJ, COVID -19 Coronavirus, Gout, Rheumatology
MedicalResearch.com Interview with: Dr Rene Oliveira Department of Internal Medicine Ribeirao Preto Medical School University of Sao Paulo Ribeirao Preto, Brazil  MedicalResearch.com: What is the background for this study? Response: As rheumatologists our background for testing colchicine for COVID-19 was the effect of the drug on gout, Behçet's disease and familial Mediterranean fever. For these diseases, the drug is able to reduce systemic inflammation by acting in some cytokine pathways which the first reports in COVID-19 suggested being the same. We found that colchicine was able to reduce systemic inflammation and diminish the length of need for supplemental oxygen and hospitalisation.

02 Feb

Posted at 11:19h in Author Interviews, CMAJ, Orthopedics, Rheumatology, Surgical Research
MedicalResearch.com Interview with: Codie Primeau, MSc Physical Therapy Student & Ph.D. Candidate (Combined MPT/Ph.D.) Wolf Orthopaedic Biomechanics Lab, Fowler Kennedy Sport Medicine Clinic Western University London, ON, Canada MedicalResearch.com: What is the background for this study? Response: High tibial osteotomy (HTO) is a surgery for patients with varus alignment (bowed legs) and earlier-stage knee osteoarthritis. By correcting alignment, HTO shifts load to less diseased parts of the knee. One of the goals of HTO is to delay or even prevent the need for knee replacement surgery later. 

21 Jan

Posted at 16:51h in Author Interviews, NYU/NYMC, Race/Ethnic Diversity, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_56448" align="alignleft" width="200"]Peter Izmirly, M.D. Associate Professor of Medicine, NYU School of Medicine  Director of Inpatient Rheumatology, Bellevue Hospital Center co-Director, NYU-Hospital for Joint Diseases Lupus Clinic Research Office Address: NYU School of Medicine  New York, NY 10016 Dr. Izmirly[/caption] Peter Izmirly, M.D. Associate Professor of Medicine, NYU School of Medicine Director of Inpatient Rheumatology, Bellevue Hospital Center co-Director, NYU-Hospital for Joint Diseases Lupus Clinic Research Office Address: NYU School of Medicine New York, NY 10016  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Knowing how many people have systemic lupus erythematosus (SLE) is limited, particularly for racial/ethnic subgroups in the United States. Our work provides accurate estimates of who has  (SLE) among the major racial/ethnic groups in the United States and that our estimates for SLE approach the FDA’s definition or a rare disease.

18 Nov

Posted at 11:08h in Author Interviews, Orthopedics, Radiology, Rheumatology, UCSF, Weight Research
MedicalResearch.com Interview with: Silvia Schirò MD Department of Radiology and Biomedical Imaging University of California, San Francisco MedicalResearch.com: What is the background for this study?  Response: Knee osteoarthritis (OA) is worldwide the second most frequent cause of lower extremity disability, and it has a global incidence of 199 cases per 100.000, including over 14 million people with symptomatic knee OA in the US. Overweight and obese individuals have a higher incidence of knee OA due to excessive knee joint load. The association between physical activity and knee OA, has not been systematically addressed in overweight and/or obese subjects and its association seems to be controversial. On the one hand, mild to non-weight-bearing physical activities have been found to be beneficial in the management knee homeostasis, the physiologic knee joint load providing an optimized environment for the joint tissues. On the other hand, excessive fast-paced physical activity with high load-joint torsion such as racquet sports, ball sports and running have been found to have an increased incidence of knee injury compared to mild-moderate exercise such as swimming, bicycling and low-impact aerobics independent of body weight.

12 Nov

Posted at 20:19h in Author Interviews, Gout, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_55936" align="alignleft" width="150"]MedicalResearch.com Interview with: Jeffrey D. Kent, M.D., FACG, FACP Executive Vice President, Medical Affairs and Outcomes Research Horizon MedicalResearch.com: What is the background for this study? What is the marker for reduced immunogenicity with Pegloticase? Response: Pegloticase is a recombinant, pegylated uricase that is used for treatment of chronic gout in patients who fail oral urate lowering therapy (uncontrolled gout) and has a demonstrated impact on the serum uric acid (sUA) level. As with other biologics, in some people the body’s immune system develops anti-drug antibodies and reduces the effectiveness of the biologic therapy. Recent case series and open-label trials have suggested that using an immunomodulator with pegloticase has the potential to increase the durability of response so patients can receive a full course of therapy. Researchers in the RECIPE trial sought to examine whether the co-administration of disease-modifying antirheumatic drugs (DMARDs), specifically mycophenolate mofetil, may mitigate this loss of efficacy and increase in response rates for people living with uncontrolled gout MedicalResearch.com: Are symptoms of gout improved as well as reduced infusion reactions? Response Results from this trial indicated that short-term concomitant use of mycophenolate mofetil with pegloticase was generally well tolerated. It was also associated with a statistically significant and clinically meaningful impact on the proportion of patients achieving and maintaining an sUA ≤6 mg/dL at 24 weeks. No infusion reactions were reported in the pegloticase/mycophenolate mofetil arm (0 or 22 patients) compared to 30 percent (3 of 10) of patients reporting infusion reactions in the pegloticase/placebo arm. It’s been well established that in patients receiving pegloticase with persistent urate lowering, they experience relatively rapid resolution of tophi indicating significant reductions in their urate burden. MedicalResearch.com: What are the main findings? Response: This is the first randomized controlled trial evaluating pegloticase co-prescribed with an immunomodulator compared to pegloticase with placebo. Data showed that 86.4 percent of patients (19 of 22) receiving co-therapy of pegloticase with mycophenolate mofetil achieved an sUA ≤ 6 mg/dL through Month 3, the primary study endpoint, compared to 40.0 percent of patients (4 of 10) receiving pegloticase monotherapy. After Month 3, all patients received pegloticase only and at Month 6 a sustained response was shown in 68.2 percent (15 of 22) of patients who had received pegloticase with mycophenolate mofetil versus 30.0 percent (3 of 10) of patients who received pegloticase and placebo. This data adds to the growing body of evidence on the concomitant use of pegloticase with an immunomodulator to ultimately help more patients receive a full course of therapy and improve outcomes and may help shift the treatment paradigm in uncontrolled gout. MedicalResearch.com: What should readers take away from your report? Response: While rheumatologists are familiar with and may use DMARDs for other autoimmune conditions to minimize the development of anti-drug antibodies and increase response to therapies, data shows that the use of an immunomodulating therapy in patients with uncontrolled gout can improve response rates. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: There is a consistent pattern demonstrating that the concomitant use of pegloticase and an immunomodulator can improve patient outcomes without introducing additional toxicities. As clinicians we understand the immense burden gout places on our patients. Future research should continue exploring options to maximize the benefit of effective treatments to improve patient outcomes. MedicalResearch.com: Is there anything else you would like to add? Response: Uncontrolled gout is a chronic, systemic inflammatory condition and we continue to see data linking it to many comorbid conditions. Horizon is evaluating the use of methotrexate to improve response rates for pegloticase. We are committed to exploring various immunotherapy co-treatment options to allow both patients and clinicians to address elevated sUA levels to minimize urate burden and avoid lasting damage to the body. RECIPE is an investigator-initiated trial led by Puja Khanna, M.D., M.P.H. and Kenneth Saag, M.D., M.Sc. Citation: Khanna P, Khanna D, Cutter G, Foster J, Melnick J, Jaafar S, Biggers S, Rahman A, Kuo H, Feese M, Saag K. Reducing Immunogenicity of Pegloticase (RECIPE) with Concomitant Use of Mycophenolate Mofetil in Patients with Refractory Gout—a Phase II Double Blind Randomized Controlled Trial [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/reducing-immunogenicity-of-pegloticase-recipe-with-concomitant-use-of-mycophenolate-mofetil-in-patients-with-refractory-gout-a-phase-ii-double-blind-randomized-controlled-trial/. Accessed November 12, 2020. [subscribe] Last Modified: [last-modified] The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website. Dr. Kent[/caption]Jeffrey D. Kent, M.D., FACG, FACP Executive Vice President, Medical Affairs and Outcomes Research Horizon MedicalResearch.com: What is the background for this study? What is the marker for reduced immunogenicity with Pegloticase?   Response: Pegloticase is a recombinant, pegylated uricase that is used for treatment of chronic gout in patients who fail oral urate lowering therapy (uncontrolled gout) and has a demonstrated impact on the serum uric acid (sUA) level. As with other biologics, in some people the body’s immune system develops anti-drug antibodies and reduces the effectiveness of the biologic therapy.  Recent case series and open-label trials have suggested that using an immunomodulator with pegloticase has the potential to increase the durability of response so patients can receive a full course of therapy. Researchers in the RECIPE trial sought to examine whether the co-administration of disease-modifying antirheumatic drugs (DMARDs), specifically mycophenolate mofetil, may mitigate this loss of efficacy and increase in response rates for people living with uncontrolled gout

07 Nov

Posted at 01:03h in Author Interviews, COVID -19 Coronavirus, Race/Ethnic Diversity, Rheumatology, UCSF
MedicalResearch.com Interview with: [caption id="attachment_55874" align="alignleft" width="151"]Milena Gianfrancesco, PhD, MPH Assistant Professor. Education Division of Rheumatology, Department of Medicine University of California, San Francisco Dr. Gianfrancesco[/caption] Milena Gianfrancesco, PhD, MPH Assistant Professor. Education Division of Rheumatology, Department of Medicine University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: This study utilized data from the COVID-19 Global Rheumatology Alliance Provider Survey, which launched on March 25th. To date, it has collected information on over 6,000 patients with rheumatic disease diagnosed with COVID-19 from over 40 countries worldwide. As COVID-19 spread across the world in the spring, and especially within the United States, it became clear that the disease was impacting certain groups more than others. Growing attention and research began to illustrate the disproportionate burden of COVID-19 among racial/ethnic minorities in the United States. We know that racial and ethnic minorities experience a higher burden of rheumatic disease risk and severity; therefore, our group was interested in examining whether the disproportionate burden of COVID-19 also affected this susceptible population.

26 Aug

Posted at 09:28h in Author Interviews, COVID -19 Coronavirus, NYU/NYMC, Rheumatology
MedicalResearch.com Interview with: Dr. Fernandez-RuizRuth Fernandez-Ruiz, MD Post-Doctoral Fellow Department of Rheumatology NYU Langone Heath  MedicalResearch.com: What is the background for this study? Response: Patients with systemic lupus erythematosus (SLE) represent a unique population in considering risk for COVID-19 with biologic, genetic, demographic, clinical and treatment issues at play. By the nature of their chronic inflammatory autoimmune condition, the presence of comorbidities, and regular use of immunosuppressants, these individuals would traditionally be considered at high risk of contracting SARS-CoV-2 and possibly having worse outcomes from the viral infection. However, it might be speculated that inherently elevated type I Interferon, characteristic of the majority of patients with SLE, confers a protective effect as a first line anti-viral defense. Additionally, hydroxychloroquine, which was suggested as a potential therapeutic agent for COVID-19 early on, is used in most patients with SLE. Accordingly, we initiated this study to provide critical data needed to address the frequency and severity of COVID-19 in patients with SLE.

06 Jul

Posted at 20:30h in Author Interviews, Biogen, Rheumatology
MedicalResearch.com Interview with: [caption id="attachment_54774" align="alignleft" width="150"]Nathalie Franchimont, M.D., Ph.D. Vice President Multiple Sclerosis and Immunology Development Unit Biogen Dr. Franchimont[/caption] Nathalie Franchimont, M.D., Ph.D. Vice President Multiple Sclerosis and Immunology Development Unit Biogen MedicalResearch.com: What is the background for this study? Response: BIIB059 is an investigational fully humanized IgG1 monoclonal antibody (mAb) targeting blood dendritic cell antigen 2 (BDCA2) expressed on plasmacytoid dendritic cells (pDCs), a protein present in specific cells within the immune system. An antibody against BDCA2 may potentially interrupt production of interferons, which are inflammatory molecules that are increased in patients with lupus and thought to contribute to disease activity. The LILAC study is two-part, Phase 2, randomized, double-blind trial investigating the efficacy and safety of BIIB059 in patients with cutaneous lupus erythematosus (CLE) and systemic lupus erythematosus (SLE). Data from the CLE portion of the study were recently presented at the European E-Congress of Rheumatology (EULAR) 2020, which was held virtually from June 3-6, 2020. Overall, study participants with CLE who received BIIB059 demonstrated statistically significant reduction of disease activity compared to those who received placebo, as assessed by the Cutaneous Lupus Erythematosus Disease Area and Severity Index Activity (CLASI-A) score. The results were encouraging and it warrants continued evaluation of BIIB059 in patients with CLE. Cutaneous lupus erythematosus is a chronic autoimmune disease wherein the body’s immune system attacks healthy skin, often causing rashes and skin lesions which can be painful or itchy. There is substantial unmet medical need for people with lupus given the limited number of treatment options available to manage this difficult-to-treat and chronic disease. Ultimately, we are motivated by the possibility of bringing potential new treatment options to lupus patients in need.