Overdrive by Rheumatology Network: Recent Episodes

Rheumatology Network

Overdrive is a podcast by Rheumatology Network, a publication of MJH Life Sciences. Every week we talk with healthcare experts on treatments for rheumatic disease, such as rheumatoid arthritis, psoriatic arthritis, gout, juvenile arthritis and other conditions. We also cover musculoskeletal conditions, such as osteoarthritis.

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Ahead of the American College of Rheumatology 2022 Convergence meeting on Nov. 10-14, our editorial team sat down with planning committee member Zsuzsanna McMahan, MD, MHS, of Johns Hopkins University School of Medicine, to take a deep dive into the upcoming meeting.

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Benjamin Nowell, PhD, and Stuart Silverman, MD, FACP, FACR, discuss the recent publication of a new review article, “Cannabis for rheumatic disease pain: A review of current literature.” Investigators discovered that progress in understanding cannabis-based therapies for treating the pain associated with rheumatic disease is hindered due to a lack of standardization of clinical research and current barriers to conducting such research due to federal and state regulations. Nowell is the Director of Patient-Centered Research at CreakyJoints and principal investigator of the ArthritisPower Research Registry. Silverman is a rheumatologist and Clinical Professor of Medicine at Cedars-Sinai Medical Center and UCLA School of Medicine, as well as a faculty member of the UCLA Cannabis Research Initiative.

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I sat down with Dr. Benjamin Nowell and David Curtis to chat about the the recent press release that CreakyJoints published addressing updates to their ArthritisPower interface in order to improve the user’s experience, including incorporating patient perspectives. We discuss how the changes will help both patients and rheumatologists alike, recent research, and what we have to look forward to in the near future. Dr. Nowell is Director of Patient-Centered Research at the Global Healthy Living Foundation and principal investigator of ArthritisPower and David is the Director of Technology and Data Service at the Global Healthy Living Foundation.

Time Stamps:1:05: For those who may not be aware, can you give me a bit of background on ArthritisPower?

1:58: We're discussing changes to the app. Why did ArthritisPower recently update its interface?

5:40: We've touched on how these changes will help patients who regularly utilize the app. How can it help rheumatologists as well?

6:41: The ArthritisPower Research Registry is obviously a great way to obtain information on patients living with a variety of rheumatic diseases. dod you have any updates that you'd like to share about recent research?

14:55: What do we have to look forward to, regarding research, in the near future?

17:00: Is there anything else that we haven't touched on during this interview about ArthritisPower or CreakyJoints that you'd like to address?

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On this month’s episode, I spoke with Soumya D. Chakravarty, MD, PhD, to discuss the growing body of clinical evidence evaluating joint efficacy, safety and patient-reported outcomes in patients with psoriatic arthritis receiving guselkumab.

Time Stamps:0:50: Can you tell me more about guselkumab and how it is used to treat patients with psoriatic arthritis? 

3:32: What were the study designs and methods used in developing the DISCOVER-1 and DISCOVER-2 trials?

5:43: What were the primary (and any secondary) endpoints evaluated in these trials? 

7:00: What were the results regarding efficacy, safety, and patient-reported outcomes that were presented at the ACR? 

9:23: What does this clinical research mean for both rheumatologists and their patients? 

12:07: Is there anything else you'd like our audience to know about guselkumab or Janssen before we wrap up?

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Rheumatology Network interviewed Terence Rooney, MD, to discuss the findings of a network meta-analysis that examined the efficacy of guselkumab (TREMFYA) for skin clearance and joint improvements in patients with psoriatic arthritis.

Time Stamps:

1:13: An overview of the latest analysis of TREMFYA

5:10: Can you tell me a bit more about the study design of the network meta-analysis (NMA) that was presented? 

7:35: You briefly touched on the findings of the NMA, can you go into some more detail about the precise findings? 

10:52: Were you surprised by the results of the study?

11:28: What is the clinical significance of these results?

12:28: Were there any strengths or limitations of the study that you'd like to highlight?

13:50: Is there anything else you'd like rheumatologists now before we wrap up?

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Louis Bessette, MD, MSc, discusses his ACR presentation, “Impact of Early Pain Improvement on Patient-reported Outcomes in Patients with Psoriatic Arthritis: Results from a Phase 3 Trial.” Bessette is affiliated with the Center for Osteoporosis and Rheumatology of Quebec. He explains why pain is a largely unmet need in this patient population, the study design, and further research his team plans on tackling in the future.

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On this month's episode, we interviewed Courtney Wells, PhD, MPH, MSW, to discuss the impact of COVID-19 on the quality of life of patients with rheumatic conditions, focusing on perceived risk and decision making.

Time Stamps:1:04: What first sparked your interest in quality of life during the pandemic for generally underrepresented patients with rheumatic disease? 2:27: Can you tell me a little bit about the study design and methods used by your team to ascertain quality of life and patient perspectives?  4:29: What were the key findings of your study? 6:07: Were you surprised by the results? 9:22: Were there any strengths or limitations of the study that you’d like to discuss? 11:00: Is there anything else you’d like our audience to know before we wrap up? 

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Soumya Chakravarty, MD, PhD, discusses the unmet patient needs in immune-mediated diseases as well as Janssen’s work in scientific innovation that allows patients to live their lives more unburdened by their disease. Chakravarty is the Sr Director and Strategic Lead in the Rheumatology Therapeutics area at Janssen.

Time stamps:

0:45: Why do you believe fewer than 10% of patients achieve sustained clinical remission?

3:36: What are some of the unmet needs in immune-mediated diseases? 

5:41: Are there any conditions that are especially suffering from this? 

9:44: What are some of the scientific and experience innovations that Janssen utilizes to help drive treatment advancement? 

12:21: How does Janssen focus on where the impact of disease on patients where it is highest and gaps in treatment are greatest?

16:38: How do you believe we can achieve greater numbers of patients in remission? 20:29: Can you tell me a bit about how collaboration helps patients navigate their own treatment journey? 

22:38: Is there anything else you’d like our audience to know? 

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E Michael Lewiecki, MD, discusses “Controversies in Osteoporosis” and “What's New in Osteoporosis for 2021?” We deep dive into recent controversies and trends in osteoporosis management, predictions for 2022, and how COVID-19 had impacted the treatment landscape for rheumatologists.

**Time stamps:

0:52:** What are some of the controversies in osteoporosis?

5:45: What is new in osteoporosis in 2021?

14:14: Have you noticed any trends in treatment over the past year?

15:32: Do you have any predictions for osteoporosis or osteoarthritis moving into 2022?

16:57: How do you personally deal with burnout and maintain wellness during the COVID-19 pandemic?

18:55: Is there anything else you'd like our audience to know about osteoporosis or osteoarthritis? 

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Roy Fleischmann, MD, discusses the recent Pfizer press release touching upon the safety of JAK inhibitors. He explains the recent scrutiny of JAKs, the concerns some rheumatologists have in regard to JAK inhibitors, and his personal opinions on prescribing JAK inhibiting drugs to his patients.

Time stamps:

0:47: What do rheumatologists need to know about the recent press release from Pfizer regarding the safety of JAK inhibitors?

2:47: According to analysts, the response to the safety of JAK inhibitors is not surprising. Did you expect this scrutiny in JAK inhibitors?

7:12: What are some of the concerns rheumatologist have in regards to the safety of JAK inhibitors?

9:22: What are your thoughts on prescribing JAK inhibiting drugs to your patients?

11:21: What does this mean for the future of JAK inhibitors?

11:52: Is there anything else you'd like our audience to know before you wrap up?

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Rheumatology Network sat down with Andrew L Concoff MD, FACR, CAQSM, to discuss value-based care, including the benefits, collaborate approach to working with payers, the revenue and cost savings, and how value-based care can support routine and consistent health visits.

Time stamps:

0:43: What is value-based care? 

1:04: How is value-based care different from fee-for-service models? 

4:11: What are the revenue and cost savings of value-based care? 

6:39: What are the benefits of value-based care and how does it allow for personalized patient care?

9:10: How does a collaborative approach to working with payers benefit practices and patients?

12:58: How does value-based care support routine and consistent health visits versus urgent appointments?  

15:14: Is there anything else you’d like our audience to know before we wrap up? 

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This week, we sat down with Daniel Hernandez, MD, and Shilpa Venkatachalam, PhD, MPH, of CreakyJoints, to highlight health disparities in marginalized communities and introduce their exciting new venture, CreakyJoints Espanol.

Time stamps:

1:17: The COVID-19 pandemic has exposed health disparities in historically marginalized communities, including Spanish speaking communities. What are some of the ways in which CreakyJoints is addressing these long-standing disparities? 5:51: How have health disparities impacted Spanish speaking patients living with rheumatologic conditions like arthritis? 7:59: What are some of the specific barriers that the Hispanic community faces securing access to doctor's diagnosis and treatments? 8:59: Hispanics have been underrepresented in medical research. Why is that? 9:55: CreakyJoints launched ArthritisPower more than 5 years ago. Why did you create Arthritis Power Espanol when the app was already available to all US people living with forms of joint bone and inflammatory skin conditions as well as arthritis and rheumatological manifestations of gastrointestinal tract conditions? 13:18: What do rheumatologists need to know about ArthritisPower Espanol to encourage their patients to use it? 15:04: Why and how has CreakyJoints Espanol increased its communication platforms to reach Spanish speaking patients and their families? 16:36: Why is offering bilingual evidence-based health information so important to the Hispanic community? 17:08: Looking ahead, what do you hope to learn from Spanish speaking arthritis communities about their experience of arthritis?

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This week, we sat down with Philip J. Mease, MD, to discuss his study, “Comparative effectiveness of guselkumab in psoriatic arthritis: results from systematic literature review and network meta-analysis.”

Time stamps:

0:35: Can you begin by giving me a general overview of the current treatment landscape for psoriatic arthritis?

2:12: Have you noticed any trends in treating psoriatic arthritis?

3:00: What are some of the challenges that rheumatologists face when trying to identify the most appropriate treatment option for their patients?

3:36: Why is discovering that guselkumab demonstrated efficacy that was comparable to other treatment options, such as subcutaneous TNF inhibitors so important?

5:17: Were there any limitations or strengths of the study that you would like to elaborate on?

8:21: Does your team plan on doing any further research on guselkumab for psoriatic arthritis?

9:29: Is there anything else that you'd like our audience to know about your research or psoriatic arthritis?

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In this episode of Overdrive, the Rheumatology Network podcast, Dr. Kim Gorgens interviews Shereen Mahmood, MD, a rheumatologist with the Montefiore Medical Center in South Bronx, New York, to discuss her experience as a physician during the COVID-19 pandemic. Managing rheumatic disease patients during the pandemic has had its challenges, she says, as rheumatology patients are a vulnerable patient population. They suffer from chronic conditions, often chronic pain, and they largely rely on immunosuppressants and steroids to control their condition. In this interview, Dr. Gorgens and Dr. Mahmood talk about the mental health and mental wellbeing of rheumatic disease patients during the pandemic. 

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Juana Mata was diagnosed with rheumatoid arthritis in April 2009. In May 2009 she ended up in the hospital with  a variety of symptoms and was sent home with a diagnosis of anxiety because she insisted that something was wrong. She refused to go home unless she had testing done, after the testing was completed, She was admitted to ICU with platelet count of 2,000 (normal is 150,000-450,000), she was diagnosed with thrombocytopenia and systemic lupus. If she would have gone home that day she would have died. She was scared and knew very little about Lupus, she wanted to learn, and empower others about self advocacy.

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This week marks the start of the 2020 annual meeting of the American College of Rheumatology. Some of the studies we're covering include new therapies for lupus nephritis. Belimumab was shown recently to improve renal outcomes in lupus nephritis patients when added to standard of care. It will likely emerge as a significant treatment option, says Dr. Fotios Koumpouras, fellowship program director for rheumatology at Yale School of Medicine and a Rheumatology Network board member. Dr. Koumpouras breaks down his highlights in this interview.

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Patients with inflammatory arthritis and osteoarthritis should be participating in four different types of exercise: cardiovascular, strength, flexibility, and balance. But a new study shows that patients are overly focused on cardiovascular exercise and not enough on exercise types designed to strengthen and protect joints and bones. In this interview, Dr. Lauren Freid, a rheumatologist with the University of California Los Angeles and the lead investigator of a study on physical activity in people with inflammatory arthritis and osteoarthritis, addresses exercise essentials for inflammatory rheumatic disease.

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Gout is not only an intermittent rheumatic disease that affects peripheral joints, it’s a disease that's systemic in nature and progressive, says Dr. Bradley Marder, medical director of nephrology with Horizon Therapeutics. As a nephrologist, he sees gout as a kidney disease. In this interview, he explains why.

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In a review recently published in Current Osteoporosis Reports, Sarah French, M.D., a rheumatologist with the University of California at San Francisco, summarizes performance quality measures for osteoporosis using Centers for Medicare and Medicaid measures for pay-for-performance programs. In this interview, Dr. French shares with us her findings.

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Today we talk with Dr. Richard Furie who is chief of rheumatology at Northwell Health in New York. Dr. Furie is the lead investigator of a study on lupus nephritis just published in the New England Journal of Medicine. Dr. Furie and colleagues from the Feinstein Institutes for Medical Research reported that belimumab with standard therapy has been shown to be an effective treatment for lupus nephritis. If the treatment is approved by the U.S. Food and Drug Administration, it would be the first of its kind for this condition. In this presentation, Dr. Furie tell us more.

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Today, we talk with Dr. Jeffrey Curtis of the University of Alabama. We spoke about the use of activity trackers as a tool to record and track arthritic flare-ups. The device has been found to be useful in improving patient care or as Dr. Curtis says, “we need to right-size care” by giving patients the right care at the right time.” In this interview, he explains how an activity tracker can make such a huge difference in the care patients receive.

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In the U.S. there are about 54 million women and men, who have low bone density and are at risk of having a fracture. And, despite having access to effective treatments, most people are not being tested or treated---even high risk patients. It's a major public health concern and a crisis in medicine, says Dr.  Michael Lewiecki, who is a specialist in osteoporosis and bone diseases. Bone Health TeleECHO is filling this gap in medicine. Today, Dr. Lewiecki tells us how.

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Since the start of the COVID-19 pandemic early this year, there have been a number of studies published to test the effectiveness of hydroxychloroquine as a possible treatment. Observational studies have been published, case reports were published and randomized controlled trials were published showing that this tried and true treatment for some rheumatic conditions doesn’t work for COVID-19.

Dr. Daniel Solomon, who is editor in chief of Arthritis and Rheumatology and chief of clinical sciences for rheumatology at Brigham and Women’s Hospital in Boston, describes the abundance of new research on hydroxychloroquine and cytokine storm syndrome as an "infodemic."

In today’s edition of Overdrive, Dr. Solomon helps us make sense of the science.

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Today, we talk with Dr. Jeffrey Sparks, a rheumatologist with Brigham and Women’s Hospital in Boston who recently addressed the importance of an interdisciplinary and individualized approach in treating rheumatic disease patients who have interstitial lung disease, a condition that can lead to worsen morbidity and mortality. Learn more in this interview.

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Managing vitamin D levels may not be as straightforward as it would seem. There are factors that should be considered that are not often communicated to patients. In today's edition of Overdrive, the Rheumatology Network podcast, we talk with Dr. Suzanne Jan de Beur of Johns Hopkins University School of Medicine. She serves as director of endocrinology at Johns Hopkins Bayview Medical Center and president-elect of the American Society for Bone and Mineral Research.

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There is an inherit risk for a break, or rupture, in the doctor-patient relationship. In this episode of Overdrive, Dr. Kim Gorgens, a psychologist with the University of Denver and a Rheumatology Network board member, and Dr. Linda Mona, a patient with chronic disease and a clinical psychologist, discuss maintaining a good relationship with your patients. Doing so holds more benefits than you may realize.