Novel Initiatives Address Complexities in Treating Rheumatic Diseases

Doctor consulting with patient presenting results on digital tablet tablet sitting at table

There are many challenges to treating autoimmune diseases such as rheumatoid arthritis and lupus. Brigham and Women’s Hospital has recently undertaken a number of new initiatives to address some of these challenges and improve patient care.

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Gravallese Tabbed to Head the Division of Rheumatology, Inflammation, and Immunity

Dr. Ellen Gravallese

Brigham and Women’s Hospital welcomes Ellen M. Gravallese, MD, as the new chief of the Division of Rheumatology, Inflammation, and Immunity. Dr. Gravallese has a long list of accomplishments in her career as a rheumatologist, immunologist and basic scientist.

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Risk for Developing RA-ILD May Be Predicted by RA Disease Activity, Prospective Study Suggests

RA-associated interstitial lung disease (RA-ILD) is one of the most common extra-articular manifestations of RA and is correlated with increased mortality. We recently performed a study investigating disease activity and RA-ILD risk using the Brigham RA Sequential Study (BRASS), which has followed more than 1,500 patients over time, some for up to 15 years, and has generated a wealth of clinical and biomarker data.

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Major Toxicity Risk Score Among NSAID Users May Help Identify Patients at Risk

Patients with RA and OA all experience chronic pain, but safe options for analgesia are limited. While NSAIDs (selective and non-selective) are commonly used in rheumatology, they can cause major toxicity. Improving the risk/benefit ratio requires a more precise understanding of risk. This study, published in Arthritis & Rheumatology,  was undertaken to derive and validate a risk score for major toxicity among NSAID users enrolled in a prior randomized controlled trial.
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Are Subsequent Cardiovascular Events Associated with DMARD Use for RA, PsA or Psoriasis?

Cardiovascular (CV) disease is a major concern for patients with systemic rheumatic diseases. In a recent study, we examined disease‐modifying antirheumatic drug (DMARD) treatments and estimated the risk of a subsequent CV event among patients who experienced a first CV event and had rheumatoid arthritis (RA), psoriatic arthritis (PsA) or psoriasis.

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Bioinformatics Core Supports Investigators Who Seek to Use Big Data

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Bioinformatics methods are increasingly applied in clinical research studies to approach research questions from novel perspectives. For example, natural language processing (NLP) enables use of information previously embedded in narrative clinical notes. Leveraging experience from the past decade in developing and applying bioinformatics tools for clinical studies, the VERITY Bioinformatics Resource Core supports investigators who seek to apply these tools to their research in rheumatic and musculoskeletal disease.

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Join the VERITY Research Community

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Pediatric and adult rheumatic and musculoskeletal diseases challenge the clinical researcher:

  • They affect the population across the lifespan,
  • They impact a broad range of patient-centered outcomes,
  • They are rarely cured, and
  • They often have multiple possible treatment strategies.

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Methodology Core Finds the Optimal Study Design for Your Innovative Research Idea

figure 1. Methodolic approaches to clinical priority areas

The VERITY Methodology Core addresses many complex methodologies that researchers encounter when studying rheumatic and musculoskeletal (MSK) disorders. These conditions persist for decades and have a profound impact on the patient’s quality of life. Epidemiologic studies to identify persons at high risk for these disorders and to identify factors leading to worse prognoses merit a high priority, and clinical trials to establish treatment efficacy are even more crucial. Both types of studies must account for the complexity of the phenotype and longevity of the clinical course. Furthermore, they must address the balance between efficacy and toxicity in treatments for rheumatic and MSK disorders.

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VERITY Enrichment Core Offers Weeklong Brigham Course in Rheumatology Clinical Research


In May 2018, 15 trainees and junior faculty in adult and pediatric rheumatology from across the United States arrived at Brigham and Women’s Hospital in Boston for the inaugural VERITY/Brigham Course in Rheumatology Clinical Research. The course is aimed at early stage investigators in rheumatology and musculoskeletal diseases who are performing clinical, epidemiologic or patient-oriented research studies.

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Mapping Monocyte States in Class IV Human Lupus Nephritis

Paul Hoover Headshot
Paul J. Hoover, MD, PhD

Prior work in Lupus Nephritis has shown that immune cell infiltration, especially that of monocytes, is associated with pathologic tissue remodeling and declining renal function. A deeper understanding of infiltrating monocytes could yield more accurate interpretations of histopathologic lesions, better disease predictors, and new therapeutic concepts. Newer technologies offer a promising path toward this goal. Single cell-RNA sequencing (scRNA-seq) enables the molecular classification of cell states based on the expression of thousands of genes, and multiplex-immunofluorescent imaging enables precise spatial localization of these cell states in the context of diseased tissue. Groundwork to merge these technologies derives from our work with the Accelerating Medicines Partnership (AMP) consortium.
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