Author Interviews, Rheumatology / 22.11.2019

MedicalResearch.com Interview with: Professor Jianmin Fang, Ph.D. Founder, CEO & CSO RemeGen MedicalResearch.com: What is the background for this study? Response: Systemic lupus erythematosus (SLE), known more commonly as lupus, is a chronic autoimmune disease in which the immune system mistakenly attacks healthy tissue. SLE can affect tissues like the skin, joints, kidneys, brain and other organs, resulting in a wide variety of signs and symptoms. With limited treatment options for lupus and the significant unmet medical needs in the treatment of autoimmune diseases, the Phase 2b study evaluated the efficacy and safety of subcutaneous RC18 (telitacicept), a potential new medicine for the treatment of systemic lupus erythematosus (SLE) versus a placebo in combination with standard therapy in patients with SLE at 48 weeks. (more…)
Author Interviews, Rheumatology / 14.11.2019

MedicalResearch.com Interview with: Benjamin Nowell, Ph.D. Director of Patient-Centered Research CreakyJoints, Principal Investigator of ArthritisPower  MedicalResearch.com: What is the background for this study? Response: Patient-reported outcomes (PROs) are important indicators of treatment effectiveness, but little is known about which PRO measures that patients find the most important to track for their disease management and to evaluate treatment effectiveness and health outcomes. In this study, we used the ArthritisPower Research Registry to evaluate which PROs patients with rheumatological conditions voluntarily selected to understand their experience of disease.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Rheumatology / 13.11.2019

MedicalResearch.com Interview with: Natalie McCormick, Ph.D. Post-Doctoral Research Fellow Clinical Epidemiology Program Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital Department of Medicine, Harvard Medical School Arthritis Research Canada  MedicalResearch.com: What is the background for this study? Response: Biologic disease-modifying anti-rheumatic drugs (bDMARDs) have improved the health and productivity of many people living with moderate-to-severe inflammatory rheumatic diseases. They are also among the highest-spend drugs in the USA, with substantial out-of-pocket costs that pose barriers to treatment initiation and adherence. To understand the drivers of ongoing bDMARD spending growth, and effective ways of containing costs, we analysed drug spending data for all bDMARD claims in Medicare Part D, Part B fee-for-service, and Medicaid over 2012 to 2016, isolating the impact of changes in drug prices from changes in utilisation.  (more…)
Author Interviews, Opiods, Rheumatology / 12.11.2019

MedicalResearch.com Interview with: Raveendhara R. Bannuru MD, PhD, FAGE Director, Center for Treatment Comparison and Integrative Analysis (CTCIA) Deputy Director, Center for Complementary and Integrative Medicine (CCIM) Asst Professor of Medicine, Tufts University School of Medicine Asst Professor of Clinical & Translational Science, Sackler School of Graduate Biomedical Sciences Division of Rheumatology, Tufts Medical Center Boston, MA MedicalResearch.com: What is the background for this study? Response: Given the current controversy regarding the use of opioids in chronic pain, we wanted to delve deeper into the efficacy and safety profiles of oral opioid drugs in osteoarthritis patients. Temporal assessments like ours can reveal peak periods of efficacy, and can provide clinicians with a blueprint for optimal durations of treatment regimens. With respect to subgroup analyses based on strength of opioid binding affinity, we sought to explore currently held paradigms that strong opioids may be useful for the treatment of severe pain, and to specifically assess their relevance in OA populations. Knowledge of the relative efficacy and safety profiles of strong versus weak opioids can give clinicians the information they need to weigh benefits and harms of specific subgroups of opioids. (more…)
Author Interviews, Rheumatology / 11.11.2019

MedicalResearch.com Interview with: Kelly Gavigan, MPH Manager, Research and Data Science CreakyJoints  MedicalResearch.com: What is the background for this study? Response: Over the past fifteen years, there have been significant improvements in quality of life among people living with rheumatic and musculoskeletal disease with the introduction of biologics and targeted therapies. However, despite a variety of treatments to try, patients often seek non-pharmacological alternative and complementary treatments, such as marijuana for medical use (MMU), to help manage their condition and symptoms. MMU is becoming increasingly available in the United States as different states legalize it under specific circumstances. Legal or not, according to a survey conducted by CreakyJoints using the ArthritisPower Research Registry (n=1,059 participants), people with arthritis are trying marijuana for medical use.  (more…)
Author Interviews, Pain Research, Rheumatology / 11.11.2019

MedicalResearch.com Interview with: Féline PB Kroon MD Department of Rheumatology Leiden University Medical Centre LUMC · MedicalResearch.com: What is the background for this study? Response: Hand osteoarthritis (OA) is a prevalent joint condition that causes pain, functional disability, and decreased quality of life, for which patients frequently consult health-care providers. Symptoms usually fluctuate over time, with episodes of joint swelling and erythema. Evidence from previous studies has shown that inflammation plays an important role in the disease, being an important predictor for pain and radiographic damage progression. Therefore, we hypothesized that inflammation could be a treatment target in OA, and we investigated this using prednisolone, a potent anti-inflammatory drug. The aim of the HOPE study was to investigate the clinical efficacy and safety of a six-week course of prednisolone 10 mg daily in patients with painful hand OA who had evidence of synovial inflammation. (more…)
Author Interviews, Gout, Kidney Disease, Rheumatology, Transplantation / 10.11.2019

MedicalResearch.com Interview with: Megan Francis-Sedlak, PhD Director of Medical Affairs Horizon Therapeutics Lake Forest, Illinois MedicalResearch.com: What is the background for this study? Response: The prevalence of gout is more than ten-fold greater among patients who have undergone a kidney transplant than the general population as post-transplant medications to prevent organ rejection can contribute to increased uric acid levels. Overall studies have shown this can lead to higher rates of uncontrolled gout among this vulnerable population with organ transplants. While we have seen higher mortality rates for patients who have received a kidney transplant with uncontrolled gout compared to kidney transplant patients without uncontrolled gout, we wanted to evaluate the impact of gout on transplant-related complications to better inform patient care and treatment approaches.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Dermatology, JAMA, Rheumatology / 09.11.2019

MedicalResearch.com Interview with: Emily S. Ruiz, MD, MPH Director, High-Risk Skin Cancer Clinic, Dana Farber/Brigham and Women’s Cancer Center Assistant Professor, Harvard Medical School, Dermatology Brigham And Women's Faulkner Hospital  MedicalResearch.com: What is the background for this study? Response: Innovation in oncology has led to increased development and market entry of anticancer drugs. For example, from 2009 to 2013, the US FDA approved 51 oral and systemic anticancer drugs for 63 indications. Prices for anticancer drugs have risen faster than inflation over time, especially for older drugs, and prices in the US have largely been set by market forces rather than novelty or efficacy. Understanding the evolving cancer economic landscape requires consideration of annual and cumulative rates of change for key metrics, such as total spending, drug cost per beneficiary, out-of-pocket cost, and utilization. This study sought to weigh the proportional impacts of rising drug costs and utilization on increased Medicare Part D spending for a cohort of oral anticancer drug utilized from 2013-2017.  (more…)
Author Interviews, Pain Research, Rheumatology / 12.09.2019

MedicalResearch.com Interview with: W. Benjamin Nowell, Ph.D. Director of Patient-Centered Research CreakyJoints, Principal Investigator of ArthritisPower MedicalResearch.com: What is the background for this study? Response: Over the past fifteen years, the treatment options for people diagnosed and living with rheumatoid arthritis (RA) have grown. There are now many medications (particularly biologic disease-modifying antirheumatic drugs, or bDMARDs) proven to improve disease symptoms and immune system over activity, thereby reducing inflammation and joint damage. The American College of Rheumatology recommends a treat-to-target approach, which has the patient and rheumatologist setting goals for treatment effectiveness and making adjustments over time to meet those goals. This study aimed to determine if rheumatoid arthritis patients are satisfied with their treatment. The goal of this study was to identify the following: patients’ satisfaction with current RA treatment, the current unmet needs perceived by patients with rheumatoid arthritis in the United States, the symptoms of rheumatoid arthritis that are most bothersome to patients, and the impact of symptoms on function and quality of life that may lead patients to need alternative treatments.  (more…)
Annals Internal Medicine, Author Interviews, OBGYNE, Rheumatology / 17.07.2019

MedicalResearch.com Interview with: Bella Mehta, MBBS, MS Assistant Attending Physician, Hospital for Special Surgery Instructor, Weill Cornell Medical College MedicalResearch.com: What is the background for this study? What are the main findings? Response: For women with lupus, pregnancy has long been considered high-risk and associated with both medical and obstetric complications. In the 1960s and 1970s, pregnancy was thought to be contraindicated in lupus patients. Beginning in the 1980s, and especially in the 1990s, many studies identified specific risk factors for pregnancy complications and proposed best-practice management guidelines. We wished to see whether these advances improved pregnancy outcomes for lupus patients. Our study showed a decline in maternal mortality and other outcomes in lupus patients. The improvement in pregnancy outcomes was observed more so in lupus patients than those without lupus.  (more…)
Author Interviews, Bristol Myers Squibb, Rheumatology / 26.06.2019

MedicalResearch.com Interview with: Sean Connolly, Ph.D. Director of Non-Registrational Data Generation Study Director for ASCORE Bristol-Myers Squibb MedicalResearch.com: What is the background for this study? Response: ASCORE is a two-year, prospective multicenter study to observe retention and response rates of moderate-to-severe rheumatoid arthritis (RA) patients receiving ORENCIA® (abatacept), administered subcutaneously via a pre-filled syringe, in routine clinical practice. Findings shared at the Annual European Congress of Rheumatology (EULAR 2019) are the results from the first 12 months. An important objective of our development program is to understand how well we can replicate findings from our clinical trials among a real-world patient population. In the case of ASCORE, which looked at approximately 3,000 patients, both bio-naïve and patients receiving later-line therapies, these data add to the body of research that may help inform physicians treating patients with RA. Patients participating in ASCORE were divided into two distinct cohorts at the outset of the study: bio-naïve and patients previously administered one or more biologic agents. The primary endpoint is to estimate the rentention rate of patients in each cohort over a 24-month period. Furthermore, ASCORE examines the patient populations across ten countries to understand factors including: how ORENCIA is prescribed, characteristics of patients from each country (socio-demographic data, medical history, co-morbidities, etc.), and population health statistics within each country. This sub-analysis is factored into patient response to treatment across both cohorts, which may help physicians better understand how and why certain populations demonstrate a specific retention rate. (more…)
Author Interviews, Orthopedics, Pharmacology, Rheumatology / 28.02.2019

MedicalResearch.com Interview with: Dr. Andrew Spitzer MD Co-director Joint Replacement Program Cedars-Sinai Orthopedic Center Los Angeles, CA MedicalResearch.com: What is the background for this study? How does this product differ from other steroid injections for inflammatory arthritis? Dr. Spitzer: Many patients receive repeat injections of intra-articular corticosteroids to manage recurrent osteoarthritis pain and other symptoms. However, in most clinical trials to date, patients only received a single corticosteroid injection, and patients were only followed for 12 to 24 weeks after treatment. For trials that have evaluated repeated injections of corticosteroids over a longer period of time—2 years, for example—injections were administered every 3 months, regardless of the timing of the return of OA symptoms. This is not reflective of what is done in clinical practice, where corticosteroids are administered again in response to the return of pain or a flare of inflammation in the knee. In this study, we used a flexible dosing schedule based on the patients’ symptoms, meaning that patients received the second injection of a recently approved extended-release corticosteroid only when their pain and/or symptoms returned, not before. Safety was monitored for 52 weeks—this length of time should be sufficient to identify any associated side effects, including any potential impact on the knee tissue. Triamcinolone acetonide extended-release (TA-ER; Zilretta®) was approved in late 2017 as an intra-articular injection for the management of osteoarthritis pain of the knee. The formulation utilizes microspheres which enable a slow release of the active agent (triamcinolone acetonide) into the synovial fluid for 12 weeks following injection. Previously, a Phase 3 study demonstrated safety and efficacy of a single injection of TA-ER (Conaghan PG, et al. J Bone Joint Surg Am. 2018;100:666-77). This is the first study evaluating the safety and patient response to repeat administration of TA-ER. This study also included patients that were more typical of who we see in the clinic—those who have higher body mass index, more severe disease, and received prior treatments for their osteoarthritis pain. (more…)
Author Interviews, JAMA, MRI, Rheumatology / 07.02.2019

MedicalResearch.com Interview with: Signe Møller-Bisgaard MD, PhD Rigshospitalet Center for Rheumatology and Spine Diseases Copenhagen Center for Arthritis Research  MedicalResearch.com: What is the background for this study?  Response: The background was that to avoid long-term consequences of rheumatoid arthritis (RA) such as progressive joint damage progression leading to functional impairment and loss of quality of life, it is essential for patients with RA to achieve clinical remission, which is a disease state with no clinical signs and symptoms of disease activity. But despite treating our patients according to current clinical recommendations using targeted treatment strategies, so that the patients reach a state of remission, joint damage progression still occurs in one out of four patients. We knew, that MRI inflammatory findings such as synovitis and bone marrow edema are present in patients in clinical remission and are of prognostic value. In particular bone marrow edema has shown to be a strong predictor of erosive joint damage progression. In the IMAGINE-RA randomized clinical trial we therefore wanted to investigate if an MRI treat-to-target strategy targeting absence of bone marrow edema versus a conventional disease activity-guided treat-to-target strategy would improve clinical and radiographic outcome in rheumatoid arthritis patients in clinical remission.  (more…)
Author Interviews, Occupational Health, Rheumatology / 01.11.2018

MedicalResearch.com Interview with: Dr. W. Benjamin Nowell, Ph.D. Director of Patient-Centered Research CreakyJoints, study co-author Co-principal investigator of ArthritisPower MedicalResearch.com: What is the background for this study? What are the main findings? Response: Rheumatoid Arthritis (RA) can diminish patients’ work productivity and increase the risk of long-term disability, economic insecurity and worsening health, but limited research informs these issues. The purpose of our study was to examine associations between patients’ RA disease activity and their productivity and workplace support, using real-world data from the ArthritisPower research registry. Our study looked at a sample of participants with RA who had a history of or current treatment with non-biologic and/or biologic disease-modifying antirheumatic drugs (DMARD) (n=296). Among the study sample, 74 percent had high disease activity (HDA) as determined by RAPID3 (>12), a common measure of disease activity in RA.
  • High disease activity was associated with lower education (p<0.001) and higher likelihood of disability (9%, p<0.001) compared to those without high disease activity.
    • Patients with HDA missed more days of work than non-HDA patients (mean: 6.1 vs 3.8 days, respectively; p=0.03), but non-HDA participants reported more days off due to medical appointments (2.6 vs 1.2 days, respectively) while HDA patients missed more days due to RA treatment side effects (mean: 0.5 vs 0.1 days, respectively).
  • Based on scores from the Work Productivity and Activity Impairment (WPAI) questionnaire, RA seems to affect work productivity to a greater extent in participants with HDA than without (WPAI scores 5.3 and 3.3, respectively; p<0.001). Participants who were not currently employed reported having more physically demanding tasks (e.g. heavy load lifting) and less workplace flexibility (e.g. working from home) in their most recent paid position than currently employed participants.
  • However, in a multivariate regression analysis, we found that participants who could request changes in work start and stop times on a daily basis were 2.9 (95% CI: 1.53, 5.46) times more likely to be unemployed (adjusting for age, disease activity, and satisfaction with social participation) than those unable to make this request (p<0.0001).
About ArthritisPower: Created by CreakyJoints and supported by a multiyear, multimillion dollar investment by the Patient-Centered Outcomes Research Institute (PCORI), ArthritisPower is the first-ever patient-centered research registry for joint, bone, and inflammatory skin conditions. The free ArthritisPower mobile and desktop application allows patients to track and share their symptoms and treatments while also participating in voluntary research studies in a secure and accessible manner. ArthritisPower Patient Governors serve as gatekeepers for researchers who seek access to registry data or solicit the community to participate in unique, voluntary studies. To learn more and join ArthritisPower, visit www.ArthritisPower.org.  (more…)
Author Interviews, Genetic Research, NEJM, Pulmonary Disease, Rheumatology / 24.10.2018

MedicalResearch.com Interview with: Joyce S. Lee, MD Associate Professor Director, Interstitial Lung Disease Program Department of Medicine Division of Pulmonary Sciences and Critical Care Medicine University of Colorado School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Rheumatoid arthritis (RA) is a common inflammatory arthritis that can be complicated by interstitial lung disease (ILD). Patients with RA-ILD share clinical characteristics with another ILD called idiopathic pulmonary fibrosis (IPF). Given the similar clinical phenotype, our goal was to see if these lung diseases (IPF and RA-ILD) shared a common genetic risk factor. The MUC5B promoter variant is the most common risk factor (genetic and otherwise) for the development of IPF. Our findings demonstrate the MUC5B promoter variant is also a strong risk factor for the development of RA-ILD among patients with RA. (more…)
Author Interviews, Bristol Myers Squibb, Rheumatology, Smoking / 24.10.2018

MedicalResearch.com Interview with: Pr Gilles Boire, M.D., M. ScService de rhumatologie Département de médecine Faculté de médecine et des sciences de la santé Université de Sherbrooke MedicalResearch.com: What is the background for this study? Response: Rheumatoid arthritis (RA) patients are heterogeneous at initial presentation, in response to treatments and according to their outcomes. No clinical features and very few biomarkers, except autoantibodies such as anti-Cyclic Citrullinated Peptides/Proteins (CCP), identify patients with divergent prognostic trajectories. To help improve early prognostic classification, we initiated 20 years ago the single center longitudinal observational Early Undifferentiated PolyArthritis (EUPA) study of consecutive patients presenting with recent-onset inflammatory polyarthritis, 90% of which fulfill classification criteria for RA at baseline. Our registry includes 739 very early RA patients (median symptom duration 3.6 months), rapidly treated to joint remission (i.e. 0/66 swollen joint) and followed over 5 years. Each patient visit is linked to biosamples and to sequential radiographs scored according to the modified Sharp/van der Heijde method. As we had the clinical impression that clinical features of recruited patients were evolving, we compared patients from 3 periods (1998-2004; 2005-2010; 2011-2017).  (more…)
Author Interviews, MRI, Pain Research, Rheumatology / 11.10.2018

MedicalResearch.com Interview with: Daniel S. Albrecht, Ph.D. Research Fellow, Department of Radiology Harvard Medical School MedicalResearch.com: What is the background for this study? Can you briefly describe what is meant by fibromyalgia? Response: Fibromyalgia (FM) is a poorly understood chronic condition characterized by widespread musculoskeletal pain, fatigue, unrefreshing sleep, memory deficits and attention difficulties, among other symptoms. FM affects an estimated 4 million adults in the U.S., but despite this prevalence, effective therapies for treating FM are lacking. Part of the reason for the paucity of effective therapeutics is insufficient knowledge of the underlying mechanisms contributing to FM. Previous work from co-senior author of the current manuscript, Eva Kosek, MD, PhD, and collaborators at the Karolinska Institute in Sweden found elevated inflammatory molecules in the cerebrospinal fluid of FM patients, which could be reflective of brain neuroinflammation in these patients. However, no study had directly assessed the presence of neuroinflammation in the brain of FM patients. Co-senior author of the study, Marco Loggia, PhD, and collaborators showed in a 2015 Brain publication that individuals with chronic low back pain (cLBP) exhibit evidence of brain neuroinflammation, specifically activation of glial cells. Our team utilized simultaneous MR/PET imaging to image brain levels of the 18 kDa translocator protein (TSPO), which is widely used as a marker of glial activation due to vast upregulation of TSPO in glial cells, e.g. microglia and astrocytes, in preclinical models of inflammation and neurological disease. Dr. Loggia sought to extend these finding in cLBP to FM, hypothesizing that activation of glial cells may also be associated with FM pathology. To this end, we used the same TSPO PET tracer to image 20 FM patients and 16 healthy controls. During a conference where I was presenting preliminary results of the fibromyalgia study, Dr. Loggia met with Dr. Kosek and discovered that, across the Atlantic, her group was performing a very similar study, imaging 11 FM patients and 11 controls with the same TSPO PET compound. They decided to form a collaboration, and logistic talks began to determine the best strategy to combine and analyze the separate datasets. In addition to PET imaging with the TSPO tracer, which is suggested to reflect activated microglia and astrocytes, Dr. Kosek’s group also collected PET scans using a tracer thought to bind specifically to astrocytes rather than microglia. This tracer was used in order to discern the relative contributions of microglia and astrocytes to any observed differences in TSPO PET signal. (more…)
Author Interviews, Rheumatology / 03.10.2018

MedicalResearch.com Interview with: Virginia Ladd, CEO   American Autoimmune Related Disease Association (AARDA) MedicalResearch.com: Would you briefly explain what is meant by autoimmune disorders? Response: Autoimmune disease is a broad category of related diseases which share both genetic and mechanistic properties.  They occur when the person’s immune system attacks the body’s own cell, and tissue. The immune system goes awry and mistakenly attacks the tissues and organs it was designed to protect. Normally the immune system protects the It does this by body by responding to invading microorganisms, such as bacteria, and viruses. Producing antibodies which are special proteins that recognize and destroy the invaders. Autoimmune diseases occur when autoantibodies attack the body’s own cells, tissue and organs. (more…)
Author Interviews, Depression, JAMA, Rheumatology / 13.09.2018

MedicalResearch.com Interview with: Andrea L. Roberts, MPH, PhD Research Associate, Department of Social and Behavioral Sciences Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: There is some evidence that depression may increase risk of autoimmune diseases. For example, among people with autoimmune diseases, more people have depression than in the general population. Also, people who have autoimmune diseases who also have depression have more severe disease symptoms. (more…)
Author Interviews, Gout, Obstructive Sleep Apnea, Rheumatology / 30.08.2018

MedicalResearch.com Interview with: Dr M Blagojevic-Bucknal Senior Lecturer in Statistics Arthritis Research UK Primary Care Centre Research Institute for Primary Care & Health Sciences Keele University Staffordshire UK  MedicalResearch.com: What is the background for this study? Response: Evidence suggests that elevated serum uric acid levels, the cause of gout, are also frequently identified in patients with sleep apnoea However, despite prevalent hyperuricaemia in patients with sleep apnoea, shared risk factors with gout of obesity and alcohol consumption, and research identifying the associations between gout and other co-morbidities, few studies have considered the possibility of an association between sleep apnoea and gout in short and long term. (more…)
Author Interviews, JAMA, Rheumatology, Statins / 31.07.2018

MedicalResearch.com Interview with: Dr Gillian E. Caughey PhD Senior Research Fellow | School of Medicine Discipline of Pharmacology THE UNIVERSITY OF ADELAIDE Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Statins are one of the most commonly prescribed medications worldwide.  Muscular adverse effects (myalgia and myopathy) are well recognised adverse effects and symptoms resolve with cessation of statins. Idiopathic inflammatory myositis (IIM) is a heterogeneous group of autoimmune myopathies that may also be associated with statin use. IIM does not resolve with cessation of statin therapy, requires treatment with immunosuppressive agents and is a severe, debilitating condition. To date, there have been no epidemiological studies examining exposure to statins and the association of histologically confirmed IIM. In our case control study of 221 cases o fIdiopathic inflammatory myositis, there was an almost 2-fold increased likelihood of statin exposure in patients with IIM compared with controls (adjusted odds ratio, 1.79; 95%CI, 1.23-2.60). After observing a significant association of statin exposure with IIM, we conducted a sensitivity analysis where we excluded those patients with necrotizing myositis as recent studies have reported this type of IIM to be associated with statin use and the presence of autoantibodies against HMG-CoA reductase. Exclusion of these specific cases from the analysis did not change our study findings and an increased risk of Idiopathic inflammatory myositis with statin exposure remained (adjusted OR, 1.92; 95% CI, 1.29-2.86).  This suggest the potential association of all types of Idiopathic inflammatory myositis with statin exposure. (more…)
Author Interviews, Eli Lilly, Lancet, Pharmacology, Rheumatology, UCLA / 26.07.2018

MedicalResearch.com Interview with: Daniel J. Wallace M.D., FACP, MACR Associate Director, Rheumatology Fellowship Program Board of Governors, Cedars-Sinai Medical Center Professor of Medicine, Cedars-Sinai Medical Center David Geffen School of Medicine Center at UCLA In affiliation with Attune Health Beverly Hills, Ca 90211 MedicalResearch.com: What is the background for this study? What are the main findings?   Response: This is the first positive study of systemic lupus erythematosus (SLE) using baricitinib,  a small oral molecule that blocks the JAK system. The human kinome consists of 500 genes and helps regulate cell surface receptor interaction. While agents that inhibit certain pathways are approved for rheumatoid arthritis and certain malignancies, this is the first study of its kind in SLE. (more…)
Author Interviews, JAMA, Karolinski Institute, Mental Health Research, PTSD, Rheumatology / 21.06.2018

MedicalResearch.com Interview with: Huan Song Associated Department of Medical Epidemiology and Biostatistics Karolinska Institutet MedicalResearch.com: What is the background for this study? Response: Earlier findings from our group (e.g. Fang et al., NEJM 2012; Arnberg et al., Lancet Psychiatry 2015; Lu et al., JAMA Oncol 2016; Shen et al., BMJ 2016; Zhu et al., Ann Oncol 2017) have identified pathways through which stressful events contribute to deterioration in human health. With strong animal models and human data supporting a role of stress in immune dysregulation, the hypothesis linking mental distress with autoimmune is indeed plausible. However, the evidence is as yet limited to clinical observations and a few larger observational studies on US veterans, most of them on men only, and some of which have cross-sectional designs and various other methodological shortcomings. (more…)
Author Interviews, Pain Research, Rheumatology, Weight Research / 19.06.2018

MedicalResearch.com Interview with: Professor Steve Messier Director of the J.B. Snow Biomechanics Laboratory J.B Snow Biomechanics Laboratory Wake Forest University MedicalResearch.com: Why did you undertake this study? Response: This was a secondary analysis of the Intensive Diet and Exercise for Arthritis (IDEA) clinical trial originally published in JAMA in 2013, Volume 310, Number 12, pages 11263-1273. We were interested to see if losing 20% of your body weight had any additional benefits compared to a 10% weight loss that we previously have shown to be beneficial. (more…)
AHA Journals, Author Interviews, Brigham & Women's - Harvard, Gout, Heart Disease, Rheumatology / 18.06.2018

MedicalResearch.com Interview with: “Gout in my foot” by vagawi  is licensed under CC BY 2.0Seoyoung C. Kim, MD, ScD, MSCE Associate Professor of Medicine Division of Pharmacoepidemiology & Pharmacoeconomics Division of Rheumatology, Immunology and Allergy Brigham and Women's Hospital, Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Since patients with gout are at an increased risk of cardiovascular events, we wanted to examine comparative cardiovascular safety of the two most commonly used urate-lowering drugs – febuxostat and allopurinol. Using claims data from US Medicare, we conducted a cohort study of 24,936 febuxostat initiators PS-matched to 74,808 allopurinol initiators. We found the risk of the primary cardiovascular endpoint (MI or stroke) was similar between the two groups. Analyses on secondary endpoints as well as all-cause mortality showed similar findings except that febuxostat was associated with a modestly reduced risk of heart failure exacerbation among patients with preexisting heart failure. In our sensitivity analysis, the risk of all-cause mortality associated with long-term use of febuxostat v. allopurinol appears to be increased but statistically not significant. (more…)
Author Interviews, Orthopedics, Rheumatology / 18.06.2018

MedicalResearch.com Interview with: Samuel Hawley | Research Assistant (NIHR PhD Project) | Pharmaco- and Device Epidemiology Group | Centre for Statistics in Medicine | NDORMS | University of Oxford  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The aim was to disentangle some of the potential reasons for the recent decline in joint replacement rates among rheumatoid arthritis (RA) patients in the developed world. The main findings from our UK patient-level analysis indicated that joint replacement rates were not significantly different for users of TNF inhibitors versus the patients who remained only on conventional synthetic DMARDS, however we did find that TNF inhibitor use amongst older RA patients was associated with a 40% reduction in hip replacement rates. (more…)
Author Interviews, Biomarkers, Rheumatology / 16.06.2018

MedicalResearch.com Interview with: Dr. Lisa van Baarsen PhD Principal Investigator at the Amsterdam Rheumatology and Immunology Cente Academic Medical Center the Netherlands  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The discovery that autoantibodies can be present years before the onset of clinical symptoms of rheumatoid arthritis (RA) enables us to study autoantibody positive individuals who are at risk of developing RA. In patients with established disease the target tissue of RA, the synovial joints, is characterized by cellular infiltration and inflammation. Moreover, successful therapy decreases this synovial inflammation. In the past, our department already showed (PMID: 21177292; PMID: 24574210) that in autoantibody positive at risk individuals there is no overt cellular infiltration present in the synovium. In the current study we performed a so called discovery-based approach to investigate at a genome-wide gene expression level (using microarrays) whether the synovium is altered at a molecular level before onset of rheumatoid arthritis. Our molecular and microscopic studies on synovial biopsies obtained from autoantibody positive individuals indeed revealed interesting differences between those at risk individuals who developed disease after follow up and those who did not. (more…)
Author Interviews, Rheumatology / 16.06.2018

MedicalResearch.com Interview with: Maarten Boers, MSc, MD, PhD Professor of Clinical Epidemiology Department of Epidemiology and Biostatistics VU University Medical Center--F wing MedFac Amsterdam, Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Mortality in rheumatoid arthritis is increased. Recent (short-term) studies suggest the situation is improving, but in studies with long (>10-year) follow up the increased mortality persists. We have been following a trial cohort of rheumatoid arthritis patients treated right from the beginning of disease (the COBRA trial) for 23 years and now, for the first time, show normal mortality compared to the general population. (more…)