ACR Journals On Air

In this episode, Drs. Nilasha Ghosh and Anne Bass discuss immune-related adverse events from immune checkpoint inhibitors, focusing on psoriasis and psoriatic arthritis. They review early clinical recognition, epidemiology, and findings from a multicenter observational study evaluating apremilast, including patient characteristics, outcomes, and key limitations. The conversation also highlights insights from the HSS Checkpoint Inhibitor–Associated Arthritis Registry, the need for greater precision in rheumatology, and practical perspectives on mentorship and career development for emerging clinician–scientists. Use of Apremilast for the Treatment of Immune Checkpoint Inhibitor Psoriasis and Psoriatic Arthritis

In this episode, Dr. Shervin Assassi discusses a secondary analysis of the SENSCIS trial, exploring how peripheral blood gene expression may predict response to mycophenolate in systemic sclerosis–associated lung disease. He highlights key findings linking immune and metabolic gene signatures, as well as C-reactive protein, to changes in lung function, and considers their potential role in guiding treatment and clinical trial design. The episode also touches on his career journey and insights into leadership, mentorship, and sustaining research productivity. Peripheral Blood Gene Expression Profiling and Prognostic Significance for the Course of Interstitial Lung Disease in Patients With Systemic Sclerosis

In this episode, Dr. Elizabeth Volkmann discusses emerging research on the gut microbiome in systemic sclerosis, building on findings from early-diagnosis and prior microbiome studies. She explains her team's analysis of microbiome-derived metabolites, including short-chain fatty acids, and their potential role in symptom development, highlighting key findings, clinical implications, and study limitations. The conversation also touches on holistic patient care, international collaboration, and her perspective on the future of systemic sclerosis research and treatment. Characterization of the Fecal Metabolome in Patients With Early Systemic Sclerosis

In this episode, we speak with Dr. Jayne MacMahon about an international collaborative study in juvenile dermatomyositis (JDM) involving pediatric rheumatology centers in Genoa, Italy, and Toronto, Canada. She discusses the study's motivation, key disease activity measures, treatment targets, and definitions of remission, along with major findings on time to remission, steroid exposure, and treatment outcomes across cohorts. Dr. MacMahon also reflects on the study's limitations, future research directions, her career path in pediatric rheumatology, and how international collaboration can shape the future of care for children with autoimmune diseases. Toward a Treat-to-Target Strategy in Juvenile Dermatomyositis: What Are the Suitable Targets and Optimal Timing of Their Achievement?

In this episode, we explore why rheumatoid arthritis matters to the broader public, with a focus on difficult-to-treat RA (D2T-RA)—what it is, how often it occurs, and why early identification is critical. Our guest demystifies common RA research terms and outcome measures, introduces the real-world data sets behind the study, and explains—in plain language—how a predictive model was developed using modern statistical tools. We discuss the key risk factors for D2T-RA, including which findings were surprising, as well as the study's major strengths and limitations. The conversation wraps up with thoughts on how this work may shape future research, the potential role of AI in risk modeling, and practical advice for early-career researchers on balancing productivity and sleep.

In this episode, we sit down with Dr. Aaron Smith to explore why the rheumatology community urgently needs stronger grounding in aging principles and more adaptable care strategies for older adults living with rheumatic conditions. Dr. Smith walks us through his innovative research examining the attitudes and perspectives of healthcare professionals, explains how tools like the ERA-12 help illuminate key patterns, and shares what his team learned about how clinicians approach the care of aging patients. He discusses which findings surprised him, what limitations shaped the study, and how this work opens new directions for future investigation. Near the end, Dr. Smith offers practical takeaways clinicians can apply right away and reflect on his own early-career journey—including what he hopes to accomplish between fellowship and the far future stages of his career.

In this episode, we talk with Dr. Sharon about the complex intersection of oncology and autoimmunity through the lens of immune checkpoint inhibitors (ICIs)—therapies that have transformed cancer care but can also unleash immune-related adverse events (irAEs). Dr. Elad explains how ICIs work, why they can trigger autoimmune-like toxicities, and what distinguishes rheumatologic irAEs from classic autoimmune diseases. We explore the mechanistic overlaps between cancer immunotherapy and autoimmunity, the ethical and clinical dilemmas of balancing immune suppression with cancer control, and emerging biomarkers that may predict risk. Dr. Sharon also reflects on his career journey—from leading drug development efforts at the National Cancer Institute to returning to academia—and shares insights on collaboration, innovation, and the evolving partnership between oncologists and rheumatologists in managing these challenging conditions.

In this episode, Dr. Shaun Jackson uses a compelling patient case to illuminate the complex mechanisms of immune tolerance and autoimmunity. He explains how B cells learn to avoid targeting the body's own tissues through central and peripheral tolerance—and how these safeguards can fail. The discussion covers the roles of germinal centers, T cells, and rare genetic disorders in shaping immune regulation, with Alport's syndrome and post-transplant Goodpasture's disease serving as striking examples. Dr. Jackson also reflects on emerging directions in autoimmune research and shares his journey from medical training in South Africa to leading a research program in Seattle, offering valuable insights for future physician-scientists.

In this episode, we review the Arthritis & Rheumatology manuscript, "Diagnosis and Treatment of Castleman Disease," with Drs. Luke Chen and David Fajgenbaum. The discussion (which provides an essential, up-to-date overview of a rare but critical disease) highlights the clinical subtypes of Castleman Disease, its overlap with autoimmune and autoinflammatory syndromes, and current diagnostic and treatment strategies. Dr. Chen offers a hematologist's perspective on disease classification, pathology, and practical management tips, while Dr. Fajgenbaum shares insights from his personal experience as a patient and his work advancing research through the Castleman Disease Collaborative Network and Every Cure.

This episode explores the ARChiVe Registry, a longitudinal database for pediatric vasculitis, with guest Dr. Sam, a pediatric rheumatologist and bioinformatician. The discussion covers the registry's design, patient selection, and key outcomes, including remission rates, hospitalization, and damage scores (pVDI) across treatment strategies. Dr. Sam highlights how these findings inform clinical practice and discusses the challenges of observational data. The episode also touches on his unique background in social pediatrics and health informatics, emphasizing the evolving role of clinicians as both diagnosticians and data stewards in rheumatology research.

Today, we explore why naming matters—especially when it comes to peripheral nervous system disorders in autoimmune diseases like Sjögren's. Dr. Shanmugam is joined by Dr. Ghaith Noaiseh and Kathy Hammitt, two key contributors to the recently published manuscript, "Recommendations for Aligned Nomenclature of Peripheral Nervous System Disorders Across Rheumatology and Neurology," in Arthritis & Rheumatology. Together, they discuss the critical importance of unified terminology across specialties, the implications for diagnosis and treatment, and how clearer, consistent language can empower both clinicians and patients. The conversation also delves into the development of Clinical Practice Guidelines and how this nomenclature effort supports interdisciplinary care, research, and patient advocacy. Tune in for expert insight and a behind-the-scenes look at a major collaborative effort to bring clarity to complex clinical conversations.

In this episode of ACR Journals on Air, host Dr. Vicki Shanmugam returns to the mic and dives into the CLASS Project—an ambitious international study on anti-synthetase syndrome recently published in Arthritis & Rheumatology. Joined by Drs. Sara Faghihi-Kashani, Akira Yoshida, and Giovanni Zanframundo, she explores the clinical characteristics, antibody profiles, and skin and lung manifestations of this complex autoimmune condition. The conversation covers everything from global collaboration challenges to nuanced antibody testing and rare clinical features like hikers' feet. With insightful perspectives from each guest, this episode sheds light on the evolving understanding of anti-synthetase syndrome and the future directions of the CLASS initiative.

Dr. Laura Plantinga joins us to discuss her recent work on the APPEAL study, which examines how lupus affects activities of daily living using patient-reported outcomes and validated measures such as IADLs, BADLs, SLAQ, and PROMIS. We explore her methodological approach, key findings, and implications for clinical practice—particularly how physicians can better support patients in managing functional limitations. Dr. Plantinga also shares insights on translating epidemiologic data into actionable strategies and maintaining scholarly productivity in academic medicine.