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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.

Compared with men, women have a higher incidence of autoimmune disease and are more affected by rheumatic and musculoskeletal diseases (RMDs). Therefore, in light of the American Medical Association (AMA)’s Women in Medicine Month, we’re highlighting the importance of recognizing women’s health in rheumatology. The American College of Rheumatology (ACR) also recently released guidelines for the management of reproductive health in women with RMDs. Our featured guest is Mehret Birru-Talabi, MD, PhD, assistant professor of medicine and associate rheumatology fellowship program director in the Division of Rheumatology and Clinical Immunology at the University of Pittsburgh, Pennsylvania. We will also be getting an expert input from lead author of the ACR guidelines on reproductive health in RMDs, Lisa Sammaritano, MD, attending physician, director of the Rheumatology Reproductive Health Program at the Barbara Volcker Center for Women and Rheumatic Disease in the Hospital for Special Surgery, New York, and professor of clinical medicine at Weill Cornell Medicine, New York.

With the increase in remote monitoring of patients and the provision of telemedicine services during the coronavirus disease 2019 (COVID-19) pandemic, the role of digital health in medicine, as wearables, electronic health records, sensors, apps, and other technologies, has come to the forefront. Especially in chronic care like rheumatology, the advent of digital health innovations and the digitization of healthcare has created new avenues for both clinicians and patients toward more efficient disease management and, in turn, potentially better health outcomes. Our featured guests are W. Benjamin Nowell, PhD, MSW, director of patient-centered research at Global Healthy Living Foundation (GHLF) and CreakyJoints®, and Jeffrey Curtis, MD, MS, MPH, professor of medicine in the Division of Clinical Immunology and Rheumatology at the University of Alabama at Birmingham.

Although biosimilars have been proven to have equivalent efficacy and no clinically meaningful differences in safety and immunogenicity from their reference products, its use in rheumatology has generated much debate among clinicians, patients, drug manufacturers, and payers. While several of these biopharmaceuticals are still in the pipeline, biosimilars of originators, including adalimumab, etanercept, and infliximab have been approved for the treatment of patients with rheumatic diseases. In this episode, we get further insight into the current state of biosimilars development and adoption in the United States vs other countries, interchangeability among adult and pediatric patients with rheumatologic conditions, nonmedical switching to biosimilars, and an overview of its potential cost benefits for the healthcare system.   Our featured guest is Jonathan Kay, MD, professor of medicine and population and quantitative health sciences, Timothy S. and Elaine L. Peterson Chair in Rheumatology, and director of clinical research, Division of Rheumatology at the University of Massachusetts Medical School in Worcester, Massachusetts.

In this episode, we get expert perspectives on the immunopathology and management of the cytokine storm in adult and pediatric patients with COVID-19. Our featured guests are Scott W. Canna, MD, assistant professor of the departments of pediatrics and immunology at the University of Pittsburgh Children’s Hospital and Randy Q. Cron, MD, PhD, professor of pediatrics and medicine at the University of Alabama at Birmingham and director of the Division of Pediatric Rheumatology at Children's of Alabama.

Ethnic/racial and gender disparities remain deep-rooted in medicine and rheumatology today. In this episode and in what is one of the most pertinent topics of our times, we discuss and highlight the disproportionate burden of rheumatic diseases and coronavirus disease 2019 (COVID-19) in ethnic minorities and the gender disparities observed in rheumatology care before and during the COVID-19 pandemic.   How can rheumatologists and rheumatology professionals, in coalition with the patient community, address the issue of potential bias and the existing health disparities?   Our featured guests are Candace H. Feldman, MD, MPH, ScD and Rosalind Ramsey-Goldman, MD, DrPH, the authors of a recent article published in Arthritis and Rheumatology on the urgent action needed with regard to the widening disparities in patients with rheumatic diseases during COVID-19. 

Telerheumatology is booming now, but will the use of technology persist after the coronavirus disease 2019 (COVID-19) pandemic resolves? Could it be the new normal? In part 2 of this series, we’re getting perspectives from an allopathic and an osteopathic physician specializing rheumatology on the evolution of telemedicine and what the future may look like for the management of rheumatologic conditions.  Our featured guest is Zsolt Kulcsar, DO, MPH, MBA, section chief at White Plains Hospital Physician Associates and physician lead of telehealth services and medical director at East Post Road Ventures in White Plains, New York.

The coronavirus disease 2019 (COVID-19) pandemic has brought telehealth to the forefront of modern medicine. Telemedicine in rheumatology, or telerheumatology, may be the future of diagnosis and treatment in rheumatology. In this 2-part episode series, we’re delving deeper into the world of telerheumatology, and asking, “Could this be the new normal?” Our featured guest is John K. Botson, MD, RPh, CCD, president of Alaska Rheumatology Alliance and rheumatologist at Orthopedic Physicians Alaska. 

COVID-19 has not only had a negative influence on the health of individuals globally, but it has also mentally and physically affected healthcare professionals. In this first episode, also in light of Mental Health Awareness Month, we discuss the effect of the pandemic specifically on the health of rheumatologists and rheumatology providers, and how this, in turn, may have an impact on clinical practices and delivering patient care. Featured guest is Max I. Hamburger, MD, Founder and Executive Chairman of United Rheumatology and Managing Partner of Rheumatology Associates of Long Island, as well as the President of the New York State Rheumatology Society. Dr. Hamburger can be reached at: maxhamburger@unitedrheumatology.com. For more, visit RheumatologyAdvisor.com or follow us on Twitter.

In this series, we look at emerging topics in the field of rheumatology from various experts. These perspectives may be related to the diagnosis and treatment of rheumatic diseases, current guidelines, practice management, patient care, and much more. Rheum Advisor on Air is the official podcast of Rheumatology Advisor, a leading publication founded by the Haymarket Medical Network.