In conversation with...: Recent Episodes

The Lancet Rheumatology

The Lancet Rheumatology launches its podcast with the Clinical Realities miniseries, in which Editors and guest hosts explore the realities of rheumatology care and research in challenging settings and among underserved and neglected patient populations across the globe. In future episodes, Editors will speak to the journal’s authors to explore their research and its impact on people’s health, health care, and health policy in this regular podcast.

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In today's episode, Sophie discusses psoriatic arthritis with Dr Ryan Hum from The University of Manchester.

Psoriatic arthritis affects between 0.1% and 1% of the general population globally, and appears to be more prevalent in certain regions. It affects men and women equally and typically appears between the ages of 30 and 55 years. Psoriatic arthritis tends to be more common in people with psoriasis affecting around 20% of individuals, but estimates can depend on the inclusion criteria studies use.

We touch on the pathogenesis of psoriatic arthritis and how it might manifest in a patient, as well as the contribution of synovial inflammation and how research into this topic contributes to our understanding of the disease. We also discuss the reasons psoriatic arthritis research is in the early stages when compared to rheumatoid arthritis.

The Review discussed can be found here: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00231-0/fulltext

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In this episode, we’re tackling a condition that affects over 374 million people worldwide—knee osteoarthritis (OA). As the most common site of OA, knee OA is a leading cause of disability and accounts for more than 12 million disability-adjusted life years globally. With prevalence rising steadily due to aging populations and increasing obesity rates, the burden of knee OA is projected to climb even further in the coming decades.

We speak with the lead author of a new study published in The Lancet Rheumatology, Dr Scott Uhlrich, from the University of Utah. The study offers fresh insights into the management of knee OA through personalised gait retraining. We’ll explore the study’s design, its clinical implications, and what the future might hold for patients with knee OA.

Read the full article:

https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00151-1?dgcid=buzzsprout_icw_podcast_September_25_lanrhe

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In this episode, we'll be discussing an issue that affects millions of people globally - low back pain. We will find out why the burden of low back pain is so high, why current management is so ineffective, what we can do from a research and care perspective to improve outcomes for patients, and whether prevention is the way forward.

We’ll also discuss a couple of papers that have been recently published in The Lancet Rheumatology looking at longer-term treatment options for low back pain, and how useful they are.

Read the Systematic Review:

https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00064-5/abstract?dgcid=buzzsprout_icw_podcast_August_25_lanrhe

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In this episode Professor Vibeke Strand discusses polymyalgia rheumatica (or PMR), a common inflammatory rheumatic disease that significantly impairs patients’ quality of life, causing fatigue, pain, and physical disability, especially in relapsing cases that often require long-term glucocorticoid treatment. However, these treatments come with considerable side effects, and many patients do not respond to treatment.

We also cover her recent publication, which explores the patient reported outcomes of a trial using sarilumab, a monoclonal antibody targeting the inflammatory cytokine IL-6, which has now been approved for treatment of PMR in the USA.

Read the full article:

https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00041-4/fulltext?dgcid=buzzsprout_icw_podcast_July_25_lanrhe

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This is a joint podcast between The Lancet Rheumatology and The Lancet Regional Health - Western Pacific with Prof Xue Li. Biologics have become a mainstay of treatment in Rheumatology in Western populations, but in many parts of Asia, especially lower-and-middle-income countries, there remains substantial inequity in access due to differences in availability and affordability.

In this episode, we explore the factors that may have delayed the popularisation of biologics in Asia, any recent policy changes and the role of biosimilars in this landscape.

Read the full article:

https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(22)00121-3/fulltext?dgcid=buzzsprout_icw_podcast_June_25_lanwpc

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In this podcast, Professor Savic talks about his recent publication that looks at treatment outcomes in patients with VEXAS syndrome, as well as what clinicians should look out for in patients (red flags), and future priorities for research.

VEXAS syndrome (short for Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome) was first described in 2020. It’s a rare, and often-life threatening, inflammatory condition primarily affecting men. It's caused by a mutation in the UBA1 gene, leading to systemic inflammation and progressive bone marrow failure. The condition can manifest with a variety of symptoms, including fevers, fatigue, rashes, and joint pain, and can affect various organs and tissues.

Read the full article:

https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00034-7/fulltext?dgcid=buzzsprout_icw_podcast_June_25_lanrhe

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This is the third and final episode of our mini-series on cell-based therapies in rheumatology, with Professor Fabian Müller and Dr Melanie Hagen from the Erlangen University, Germany. We discuss their recently published a study on a newly discovered toxicity of CD-19 targeting CAR T-cell therapy in patients with autoimmune disease, as well as the recent successes of CAR T-cell therapy, ideal patient selection, and future directions.

Read the full article:

https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00091-8/fulltext?dgcid=buzzsprout_icw_podcast_Jun_25_lanrhe

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This is the second episode of a mini series on cell-based therapies in rheumatology, with Prof. Dominique Farge discussing the use of allogeneic umbilical cord-derived mesenchymal stromal cells (MSCs) as treatment for systemic lupus erythematosus (SLE).

We cover the limited options currently available for people with severe or refractory SLE, the complexities in using MSCs, Prof. Farge's recent study results, and how these results fit in with the evidence available, as well as the future for this area of research.

You can find the study here:

https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(24)00298-4/fulltext?dgcid=buzzsprout_icw_podcast_25-04-25_lanrhe

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The first episode of a mini series on cell-based therapies in rheumatology, with Prof Rebecca Marsh and Grant Schulert discussing the use of allogeneic haematopoietic stem-cell transplantation for children with refractory systemic juvenile idiopathic arthritis and associated lung disease.

Read the full article:

https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(24)00275-3/fulltext?dgcid=buzzsprout_icw_podcast_generic_lanrhe

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Dr Bryant England discusses the use of TNF-inhibitor versus non-TNF inhibitor biological or targeted synthetic DMARDs for treatment of rheumatoid arthritis-associated ILD, and the effects on survival and respiratory hospitalisation outcomes.

Read the full article:

https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(24)00265-0/fulltext?dgcid=buzzsprout_icw_podcast_generic_lanrhe

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Dr Brooke Conley and Associate Professor Ivan Lin discuss their recent study on integrating evidence from lived experience of Aboriginal people and clinical practice guidelines to develop arthritis educational resources.

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Dr Mark Russell and Sherry Yang discuss the factors influencing initiation of biologics in underserved populations with rheumatoid arthritis in the UK, how historical redlining and present-day racialised economic segregation affects health-care utilisation of adults with rheumatic diseases in the USA, and health inequities seen in rheumatology more broadly.

Read the full article:
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(24)00221-2/fulltext?dgcid=buzzsprout_icw_podcast_generic_lanrhe

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Dr Quirine Dumoulin discusses the efficacy of a 1-year course of methotrexate on the development of rheumatoid arthritis in ACPA-negative people with clinically suspect arthralgia and predicted increased risk of rheumatoid arthritis.

Read the full article:
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(24)00196-6?dgcid=buzzsprout_icw_podcast_generic_lanrhe

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Dr Sebastian Sattui discusses the effects of age and frailty on the risks of end-stage renal disease, death, and severe infection in older adults with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis.

Read the full article:
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(24)00193-0/fulltext?dgcid=buzzsprout_icw_podcast_generic_lanrhe

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To celebrate 5 years of The Lancet Rheumatology, international advisory board members Oliver Distler, Laura Coates, and David Liew discuss recent progress made, challenges to overcome, and future directions in rheumatology.

Read the associated Editorial:
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(24)00245-5/fulltext?dgcid=buzzsprout_icw_podcast_generic_lanrhe

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Dr Karen Schreiber, Professor Ian Giles, and Professor Angela Tincani discuss the Series on Pregnancy and Rheumatic Diseases, including the use of DMARDs during pregnancy, study design and conduct, and outcomes for children born to mothers with rheumatic diseases.

Read the Series:
https://thelancet.com/series/pregnancy-rheumatic-diseases?dgcid=buzzsprout_icw_podcast_generic_lanrhe

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Dr Maria Tektonidou discusses the results of a cross-sectional analysis of international data on cardiovascular risk factors in systemic lupus erythematosus.

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Dr Rosemary Hollick, University of Aberdeen, discusses a mixed-methods study on key health system components associated with improved outcomes to inform the re-configuration of services for adults with rare autoimmune rheumatic diseases.

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Editors Heather Van Epps and Anna Clark join guest hosts Lola Falasinnu, David Liew, and Puja Mehta to reflect on the progress of The Lancet Rheumatology and share their vision for the future. 

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Dr Shirin Heidari, Prof James Wason, Dr Karen Schreiber, and Prof Cheryl Barnabe join guest host Dr David Liew to discuss how sex and gender impact research design and reporting and improvements that can be made.

Learn more:
The Lancet Summit: Sex and gender in rheumatology

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Drs. Randy Cron and Chandrika Bhat join guest host Dr Puja Mehta to discuss the opportunities and challenges of cross-speciality research. 

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Prof Michael Weisman joins guest host Dr Lola Falasinnu to discuss the challenges of conducting clinical trials in rheumatology and recent developments in trial design.

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Prof Catherine Nelson-Piercy and Dr Lizemarie Wium join guest host Dr Puja Mehta to discuss the importance and challenges of obstetric medicine in rheumatic diseases. 

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Greta Lindenmayer, Stephen Brady, and Onika Paolucci join guest host David Liew to discuss specialist considerations for the care of Australian Aboriginal patients with lupus.

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Clinical Realities: Duncan Porter and Shahir Hamdulay discuss the challenges facing rheumatology care in the UK in 2022, and what's needed to improve care in the coming years. 

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Dr. Thomas Bush joins guest host Dr. Lola Falasinnu to discuss climate change and the potential adverse health effects of climate hazards for patients with rheumatic diseases. 

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Dr. Coziana Ciurtin and Dr. Kate Webb join guest host Dr. Puja Mehta to discuss the challenges and opportunities involved in transitional care for adolescent patients with rheumatic diseases as they progress to adulthood.

Read the profile of Puja:
Puja Mehta: taking the path untrodden

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Dr. Dzifa Dey joins guest host Dr. David Liew to discuss innovations in providing specialist rheumatology care and patient education in Ghana, and how her experiences in Africa could help inform development of rheumatology care in other low-resource settings.

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Dr. Eric Peters and Prof. Jinoos Yazdani join Editor-in-Chief Heather Van Epps to discuss the challenges of providing specialist rheumatology care to undocumented immigrants in the USA.