Avsnitt
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The 2026 ACR Guidelines for Juvenile Idiopathic Arthritis (JIA) are here, and lead author Dr. Karen Onel joins us to unpack the key updates shaping pediatric rheumatology care. From a biologics-first approach in systemic JIA to more individualized treatment pathways for non-systemic disease, the new recommendations emphasize earlier intervention, faster treatment tailoring, and risk-based decision-making. Dr. Onel also discusses the guidelines' broader focus on mental health, physical activity, rehabilitation, and the challenges of growing up with a chronic illness. More than an update to treatment algorithms, these guidelines reflect a fundamental shift in philosophy—one that puts the whole child, not just the diagnosis, at the center of care.
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In the future, can autoimmune disease become curable? A groundbreaking study from Germany suggests there may be a pathway in some cases. Patients with severe, treatment-refractory lupus who received CD19 CAR-T cell therapy have remained in drug-free remission for up to five years without ongoing immunosuppression. In this episode, we discuss how these findings are shifting the conversation from disease control to the possibility of cure, and what they could mean for lupus, inflammatory myopathies, systemic sclerosis, vasculitis, rheumatoid arthritis, and autoimmune diseases more broadly. We also explore CAR-T therapy, immune resets, regulatory T cells, relapse risk, and the future of rheumatology with Dr. Georg Schett.
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Saknas det avsnitt?
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Fifty years ago, pediatric rheumatic disease was often marked by disability, limited treatment options, and low expectations for long-term outcomes. In 1976, a small group of clinicians and scientists helped launch a new understanding of immune-mediated disease in children and laid the foundation for modern pediatric rheumatology. In this episode, we explore how the field evolved from managing chronic disability to expecting remission, transforming both treatment and quality of life for children. We also examine the scientific breakthroughs, models of care, and remaining challenges that continue to shape the future of pediatric rheumatology.
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Today, we discuss a new guidance statement from the American College of Rheumatology aimed at bringing much-needed structure to the evaluation and management of patients with VEXAS. This episode breaks down key recommendations, including who should be tested, the best approaches to diagnostic evaluation, how to interpret bone marrow findings, and emerging strategies for treatment—offering clarity in a diagnosis that, until recently, was marked by uncertainty.
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Private rheumatology practice is contracting under multi-directional pressure: shrinking margins, escalating prior authorizations, tightening Pharmacy Benefit Managers (PBM) and payer restrictions on drug access, and instability across core revenue streams. At the same time, demand is rising, wait times are surging, and workforce shortages are intensifying—driving clinician burnout and retention challenges.
This episode is about The American College of Rheumatology's response, in expanding its leadership role in advocacy, health policy reform, and workforce development to help private practices move from survival to sustainable growth.
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Pericardial Disease is couched between two medical disciplines: Cardiology and Rheumatology, and those with these conditions visit medical professionals viewing their treatment through one lens or the other. This episode addresses the shifting reality that pericarditis and myocarditis are no longer separate silos but rather takes the broader view of inflammatory heart disease. We'll examine how rheumatologists should be thinking about pericardial disease, when we should get involved, how diagnosis and imaging fit in, plus the evolution of treatment.
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For years, myositis treatment has relied on broad immune suppression with drugs like steroids, methotrexate, and rituximab—but what if we could target the disease more precisely? Inflammatory myopathies are not a single condition, but a group of biologically distinct syndromes with different clinical features and immune pathways. As our understanding evolves, so does the potential for more personalized, targeted therapies. In this episode, we're joined by Dr. Julie J. Paik to discuss how this shift could reshape the future of myositis treatment.
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In this episode, we discuss the growing workforce challenges in rheumatology with nurse practitioner Chris Estes. Chris shares how he entered the field, the training he received early in his career, and how he developed expertise in musculoskeletal ultrasound. The conversation explores how advanced practice providers (APPs) can help address rheumatology workforce shortages by expanding access to care—seeing new patients, managing follow-ups, and working both collaboratively and independently within a practice. Chris also discusses training pathways for new APPs, common misconceptions practices may have, and how investing in APP development may be an important strategy for the future of rheumatology care.
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In this episode, we explore the paradox of gout—one of the most biologically understood and treatable diseases in medicine, yet still among the most poorly controlled chronic conditions in practice. With effective therapies readily available, why do patients continue to cycle through painful flares, start and stop medications, and return to clinics and hospitals in a pattern that feels like a recurring failure? We unpack the complex interplay between biology, patient behavior, medication adherence, and health system barriers, asking whether the problem lies in the disease itself or in how care is delivered. As new treatments emerge, we also question whether innovation alone can solve the problem—or whether lasting change requires fixing the systems struggling to fully use the tools already at hand.
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In this episode, we explore Antiphospholipid Syndrome (APS) with Dr. Yu (Ray) Zuo, beginning with a clear, clinically grounded explanation before diving into the personal and scientific journey that drew him to this notoriously complex disease. Along the way, Dr. Zuo shares a case that forever changed how he understands APS, then takes us inside his latest Arthritis & Rheumatology study, where machine learning reveals hidden patterns that may reshape how we think about patients and risk. The conversation moves from bedside to bench and back again, tackling what AI can—and can't—do for rheumatology, where APS research is headed next, and what early investigators need to know to build impactful careers.
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In this episode, we sit down with Dr. William Harvey, the newly appointed President of the American College of Rheumatology and a dedicated volunteer of nearly 20 years. Dr. Harvey shares what it's like stepping into the presidency, the key priorities shaping the year ahead, and how the ACR is approaching strategy, advocacy, partnerships, and leadership during this pivotal moment for the field.
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In this episode, our expert guest challenges a common assumption by explaining why the T-score—despite being central to osteoporosis diagnosis—is surprisingly easy to misinterpret. He walks us through how to read a DEXA scan like a detective, highlighting subtle clues that can dramatically improve diagnostic accuracy for your patients. Once osteoporosis is identified, the conversation turns to clinical decision-making: how to choose between anabolic agents, denosumab, and bisphosphonates, and why that choice depends on thoughtful risk stratification and patient-specific comorbidities. We also dive into the often-overlooked importance of sequencing osteoporosis medications correctly, including a compelling discussion on why starting with an anabolic agent may offer greater long-term benefits than reserving it as a last-line option.
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In this episode, we explore malignant atrophic papulosis—also known as Degos disease—an extraordinarily rare microvascular disorder so uncommon that most clinicians will never see a single case. For decades, medical literature labeled it "uniformly fatal." Our guest, Dr. Lee Shapiro, encountered this reality when he began treating a rapidly deteriorating 16-year-old boy with no clear treatment path. Driven by urgency, he reached out to experts across the country, slowly piecing together clues that ultimately led to the first successful treatment of systemic Degos disease. Today, Dr. Shapiro is a leading advocate for patients, connecting a global community, promoting early recognition, and working tirelessly to expand access to life-saving therapies.
Learn more at The Degos Disease Foundation
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Once the prescription is written, pharmacists like Katherine McCarthy step in—often becoming the steady guide patients rely on throughout their health journey. Specializing in the care of people with rheumatic diseases, Katherine tackles insurance barriers, supports patients through biosimilar transitions, and helps demystify complex medication regimens. Her work underscores just how pivotal pharmacists are in driving better outcomes in rheumatology.
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This episode explores the evolving intersection of rheumatology and cognitive science, beginning with what initially drew researchers to investigate cognitive symptoms in patients with rheumatoid arthritis (RA). We discuss the prevalence and nature of patient-reported cognitive concerns, how these subjective complaints compare with objective neurocognitive testing, and what current studies reveal underlying inflammatory and neurobiological mechanisms. The conversation examines the cognitive effects of commonly used RA therapies, as well as modifiable contributors—including physical activity, sleep apnea, diet, and stress—that clinicians should assess in routine practice. We also consider when formal neuropsychological evaluation is warranted, how to counsel patients seeking to prevent cognitive decline, and the most pressing unanswered questions that remain in the field.
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In this episode, we explore what happens when clinicians look beyond the prescription pad and begin listening more deeply to what their patients have lost. This isn't a conversation about rejecting medications but about expanding the tools we use to foster healing. We discuss the concept of disenfranchised grief—the often-unspoken losses that accompany chronic illness—the intricate links between depression and inflammation, and the transformative power of helping patients heal in ways that no pill alone can achieve.
This episode was sponsored by Pfizer
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In this episode, we shine a light on Calcium Pyrophosphate Deposition Disease (CPPD)—a condition that has been hiding in plain sight for decades. Despite being common, painful, and prevalent in clinics everywhere, CPPD has long been misdiagnosed, undertreated, and under-researched. Our guest has been working to change that by uncovering the genetic and molecular underpinnings of the disease and exploring new ways to improve patient outcomes. We discuss what's new and what's next for CPPD, why it may be the most common inflammatory arthritis after age 60, how it overlaps with rheumatoid arthritis and osteoarthritis, and what emerging studies of biologics are revealing about its biology and untapped therapeutic potential.
This episode was sponsored by Pfizer
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In this episode, we explore RheumCode, a groundbreaking new initiative from the American College of Rheumatology (ACR) designed to build a common digital language for rheumatology. RheumCode aims to ensure that data means the same thing wherever it lives—whether in an EHR, a clinic, or a registry—enabling systems to seamlessly communicate and make better use of the medical information already being documented. We discussed how RheumCode began, the collaboration behind its development, and its potential to transform the way clinicians practice; researchers study disease, and patients experience their care.
This episode was sponsored by Pfizer
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Welcome to ACR Convergence 2025 in Chicago! Here, Dr. Hausmann delivers a quick update on what our podcasts will cover while the meeting is in session. Don't forget to tune in to ACR on Air and ACR Journals on Air each morning, starting this Saturday, to catch up on the latest in Rheumatology
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In this week's episode, we dive into the ins and outs of the rheumatology musculoskeletal ultrasound certification process—what it takes to log 150 scans, meet CME requirements, and ultimately sit for the exam. We're joined by Dr. Liudmila Kastsianok, who shares her insights on how ultrasound is reshaping clinical practice, from enhancing diagnostic accuracy to opening new avenues in research. We also explore how incorporating ultrasound into routine care can deepen the physician-patient relationship and improve communication. Finally, Dr. Kastsianok offers her perspective on where the field is headed and why ultrasound is becoming an essential skill for the next generation of rheumatologists.
- Visa fler
