THE OFFICIAL NEWS SOURCE OF ACR CONVERGENCE 2022 • NOVEMBER 10-14



Understanding comorbidities crucial in care of lupus patients

A panel of experts will discuss various issues involved in the management and treatment of lupus patients, including comorbidities that affect lupus patients and how to monitor for them, the role of patient-reported outcomes, and the factors that contribute to treatment adherence in lupus patients.

The symposium Living Well With Lupus will take place from 8:30 – 10:00 am today in Hall E.

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Karen H. Costenbader, MD, MPH

Karen H. Costenbader, MD, MPH, Associate Professor of Medicine at Harvard Medical School and Director of the Lupus Program at Brigham and Women’s Hospital in Boston, will discuss long-term outcomes in systemic lupus erythematosus (SLE), including a review of recent data about overall survival, malignancies, cardiovascular disease, infections, and osteoporosis.

“When it comes to malignancies, in particular hematologic and HPV-induced malignancies in SLE, rheumatologists should have an understanding of the HPV vaccine and malignancy risks associated with use of cyclophosphamide and azathioprine,” Dr. Costenbader said. “In terms of cardiovascular disease risk in SLE, high SLE disease activity and receipt of glucocorticoids contribute to many of the potentially preventable sequelae that SLE patients suffer.”

Dr. Costenbader will also summarize the types of infections that SLE patients develop and whether PCP prophylaxis, in particular, is necessary, as well as osteoporotic fractures in SLE patients and the conflicting thoughts about the use of bisphosphonates in young women with SLE.

“Knowledge and awareness of the longterm comorbidities of SLE are crucial to keeping our patients healthy in the long term,” Dr. Costenbader said. “Screening, preventive care, and surveillance, as well as risk-factor modification whenever possible, are of upmost importance.”

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Meenakshi Jolly, MD, MS

In another presentation, “How Do You Know Your Patient is Better: Biomarkers and Patient Outcomes,” Meenakshi Jolly, MD, MS, Associate Professor and Director of the Rush Lupus Clinic at Rush University Medical Center in Chicago, will discuss the pros and cons of biomarkers and patient-reported outcomes and new strategies for assessing patient improvement in lupus.

“From a patient’s perspective, the premise of improvement is simple. Improvement for them is when they see or feel a perceptible difference in their functioning health and/or quality of life,” Dr. Jolly said. “This can be measured in a systematic and standardized manner using patient-reported outcomes — data that is easily collected and involves patients’ participation in their own care. The information obtained is unique and complimentary to physician-assessed outcomes.”

When it comes to the use of biomarkers, such as the level of circulating dsDNA antibody in the blood, Dr. Jolly said their role to track progress has been studied but noted that not all lupus patients have dsDNA, and it may not always run parallel to improvement in patients’ clinical symptoms.

“Furthermore, specific organ involvement is not always immediately perceptible to the patients and, thus, one may need a variety of laboratory investigations to follow changes in the disease to allow for tracking improvement,” she said. “Research is ongoing in the search for ideal biomarkers and their utility for lupus. Neither biomarkers nor patient-reported outcomes alone, however, are the ideal method to follow improvement in lupus. We need to explore avenues that combine the strengths of each of these to our advantage.”

This symposium will also include a presentation by Hermine I. Brunner, MD, MSc, MBA, Professor of Pediatrics and Director of Rheumatology at Cincinnati Children’s Hospital, and Scientific Director of the Pediatric Rheumatology Collaborative Study Group, who will talk about the challenges of assessing and addressing adherence in lupus patients.

CLINICAL PRACTICE TRACK
Living Well With Lupus
8:30 – 10:00 am Today • Hall E