Michigan Medicine Rheumatology Newsletter

MICHIGAN MEDICINE DIVISION OF RHEUMATOLOGY

FALL 2020

Dear Faculty, Staff, Alumni, and Friends,

The American College of Rheumatology (ACR) Convergence 2020, taking place November 5 - 9, 2020, is just around the corner. Our Division has many faculty and staff participating - view the complete list. We have highlighted a few presentations that our faculty will be giving farther down in the newsletter. We are also hosting a virtual alumni reception on Thursday, November 5, from 6:00 - 7:00 pm. The details are also included below. I hope that you can join us!

This newsletter also spotlights news stories, honors and recognition, and recent publications that reflect our research efforts in COVID-19 and many other areas. I hope you enjoy learning what our Division has been doing these past few months.

I hope this newsletter finds you and your family well and safe. To stay current on our work in patient care, research, and education, please regularly visit the Division of Rheumatology website. As always, we welcome your comments and suggestions - please send us an email to umrheumatologydivision@umich.edu.

Sincerely,

John Varga, MD

Chief, Division of Rheumatology

Frederick G. L. Huetwell Research Professor of Rheumatology

Professor of Internal Medicine

Please click here for a complete list of Michigan Medicine physicians and researchers who are participating in the 2020 American College of Rheumatology (ACR) Convergence. Listed below are just a few of the many presentations/abstracts our faculty will be presenting at the meeting.

Yu (Ray) Zuo, MD, along with a team of Michigan Medicine collaborators, recently conducted a study that looked to comprehensively evaluate the role of prothrombotic autoantibodies in a large cohort of hospitalized COVID-19 patients. Patients with COVID-19 are at high risk for thrombosis of the arteries and veins. The goal of this study was to determine if the presence of autoantibodies was a factor in these occurrences. The team took serum samples from 172 patients hospitalized with COVID-19 and analyzed them for eight different types of autoantibodies. Results from the study showed that a significant percentage of these patients become at least transiently positive for prothrombotic autoantibodies and they were associated with more severe respiratory disease. Notably, purified antibodies from those patients promoted thrombosis in a mouse model. Dr. Zuo was selected to present the study’s findings "Prothrombotic Antiphospholipid Antibodies in COVID-19" at 11:45 am during the Plenary Session 1 on Friday, November 6.

Beth Wallace, MD, MSc will be presenting "Obtaining Funding from a Disease-Specific Organization" at 7:00 pm on Friday, November 6. The content is geared towards pre-fellowship trainees, fellows, and early career faculty who are interested in a research career in rheumatology. Dr. Wallace will be covering the below topics:

What are the priorities, goals, and incentives of disease-specific organizations? How can these help you when applying for funding?
What should you do before you apply for funding from a disease-specific organization?
What funding opportunities are available for investigators at different career levels?

David Fox, MD will be presenting "Career Development in Academic Rheumatology" at 1:00 pm on Saturday, November 7. The focus of Dr. Fox's talk is on the challenges that young academic rheumatologists and the rheumatology divisions face in successful career development, especially for physician-scientists who are pursuing a career that includes research (basic, clinical, or translational). He will review the elements that need to be in place to increase the likelihood for success. This issue was highlighted in the last ACR report on academic rheumatology and continues to be an important focus for the ACR division chiefs’ forum.

Jason Knight, MD, PhD will be presenting "What to Expect from a New Decade for APS" at 3:30 pm on Saturday, November 7. Dr. Knight will discuss the below key topics:

Personalization - Treating APS proactively rather than reactively
Immunomodulation - Treating APS at its source
Diversification - Getting more investigators interested in APS

David Fox, MD; Jacqueline Madison, MD; and Ajay Tambralli, MD will be participating in the ACR Knowledge Bowl, a quiz show modeled after the game show “Jeopardy.” Teams of fellows-in-training and faculty members from around the country and the world compete against each other for the prestigious title of Knowledge Bowl Champion. The preliminary round takes place at 6:00 pm on Sunday, November 8. The top three teams will advance to the final round on Monday, November 9 at 1:00 pm.

Please join us for a virtual Alumni Reception taking place on Thursday, November 5, 2020 from 6:00 - 7:00 pm EST.

David Fox, MD will give opening remarks and introduce our new Division Chief,

John Varga, MD, who will give a brief update on the state of the division and future vision. Speakers will also include faculty members Julia Ford, MD; Aaron Stubbs, MD; Beth Wallace, MD, MSc; and Yu (Ray) Zuo, MD.

The event will conclude with an open forum to share memories, ask questions, and learn more about Dr. Varga.

If you haven't already done so, please click here to register and submit questions for Dr. Varga in advance.

Look for an email with Zoom meeting information on Monday, November 2.

In the News

Systemic Sclerosis Patients Share Their Perspectives and Needs in Treatment Trials

Dinesh Khanna, MD, MSc discusses patients' ratings of their most impactful symptoms and the importance of including them in clinical trials as primary or secondary endpoints. Read more on MDedge Rheumatology.

‘COVID-somnia’ & ‘Painsomnia’: Why You Can’t Sleep During the Pandemic, and 8 Tips to Help

Vivek Nagaraja, MBBS explains how sleep issues affect people with chronic pain and arthritis, and provides tips on how to get better sleep. Read more on CreakyJoints.

Risks Are Associated with Short Courses of Corticosteroids

Beth Wallace, MD, MSc discusses the association between even short bursts of corticosteroids and severe adverse events. Listen to the interview with the New England Journal of Medicine Journal Watch.

Dr. Wallace also comments on the need for providers to closely monitor patients who are on long-term low-dose glucocorticoids for adverse effects. Read more on Medscape.

Taubman Institute Supports First U-M Based COVID Study

Jason Knight, MD, PhD; Yogen Kanthi, MD (Cardiovascular Medicine); and Yu (Ray) Zuo, MD launch a clinical trial to assess the effects of dipyridamole on deadly blood clots that form in some patients with COVID-19. Read more on Taubman Institute News.

Patients with Lupus More Likely to Skip Doses, Delay Filling Prescriptions Due to Cost

Deeba Minhas, MD finds that patients with systemic lupus erythematosus are more likely than those in the general population to report cost-related non-adherence to prescriptions. Read more on Healio Rheumatology.

Dr. Minhas also provides strategies for parenting with psoriatic arthritis in Everyday Health and discusses the effects that ankylosing spondylitis has on the ribs and tips for managing them, also in Everyday Health.

#4 Most Highly Cited Publication by the Journal of Immunology

"A Synthetic TLR3 Ligand Mitigates Profibrotic Fibroblast Responses by Inducing Autocrine IFN Signaling", co-authored by John Varga, MD and Swati Bhattacharyya, was ranked #4 by the Journal of Immunology as one of the most highly cited publications in 2019.

Retired Faculty in the News

Robert Ike, MD, Associate Professor Emeritus, recently published "Arthroscopy in Rheumatology: A Reminiscence" in the Journal of Surgery and Surgical Technology. In this article, Dr. Ike reflects on the beginnings of arthroscopy and how this procedure has evolved through the years.

Awards, Honors & Recognition

Stacey Anderson, a research area specialist with the Michigan Medicine Myositis Program, was selected to join The Myositis Association (TMA) Myositis Maven Ambassador Pilot Program. This council will be integral in the development of TMA’s newest training programs aimed at strengthening their myositis support group program and launching community educators to raise awareness of myositis through community outreach efforts.

Puja Khanna, MD, MPH was selected as a U-M Medical Group Physician Champion to lead the continued evaluation and implementation of a new lab monitoring program in MiChart as the current platform is discontinued. Over 10,000 patients from over eight specialties who are prescribed high-risk medications will be migrated to the new MiChart platform. Successful validation and implementation of this functionality will play a crucial role in patient safety and quality outcomes at Michigan Medicine.

Elena Schiopu, MD was selected by the Senate Advisory Committee on University Affairs (SACUA) to serve on the President’s and Provost’s COVID-19 Faculty Council. This new committee is charged with aiding U-M’s ongoing response to the COVID-19 pandemic. The council will meet throughout the academic year to bring forward ideas, discuss concerns, consult, and advise on issues arising from the pandemic and its effect on campus. Dr. Schiopu was selected from a large pool of highly qualified applicants and is one of 16 faculty members to serve on the committee.

Beth Wallace, MD, MSc was selected to participate in the Department of Internal Medicine’s Clinical Trials Academy. This competitive 6-month program is offered by the Department to help early career investigators learn the fundamentals of trial design by developing a clinical research protocol to submit for independent funding. Dr. Wallace’s proposal focuses on an adaptive clinical trial to assess the effect of tailored glucocorticoid tapering on health-related quality of life among rheumatoid arthritis patients.

Research

Shannon Estadt, a graduate student in Dr. J. Michelle Kahlenberg’s lab, received the Ruth L. Kirschstein Predoctoral Individual Fellowship National Research Service Award (F31) from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). This highly competitive award will support her graduate school training for three years. During this time, Ms. Estadt will work to elucidate the mechanisms by which type I interferons (IFNs) promote keratinocyte cell death following exposure to ultraviolet (UV) light. Specifically, she is interested in understanding how type I IFN-regulated genes, including pro-apoptotic Xaf1 and chemokines that promote natural killer cell recruitment and activation, may contribute to photosensitive responses in the skin. This work will hopefully identify new factors important in IFN-driven regulation of photosensitivity that can be utilized for novel treatment options for SLE patients whose disease is flared by the sun.