At this year’s American College of Rheumatology annual meeting, HSS presented exciting research related to rheumatology and orthopedic surgery. Highlights include an assessment to develop better methods to quantify joint damage in people with rheumatoid arthritis (RA), identification of risk factors for “long haul” COVID-19 in patients with rheumatic diseases, racial and ethnic disparities in lupus and pregnancy outcomes, and real-world treatment patterns of psoriatic arthritis (PsA).

Researchers Present Global Effort to Develop Machine Learning Tools for Automated Assessment of Radiographic Damage in Rheumatoid Arthritis

• A multicenter team led by S. Louis Bridges, Jr., MD, PhD, physician-in-chief and chair of the Department of Medicine at HSS, presented the results from the RA2-DREAM Challenge, a crowdsourced effort focused on developing better methods to quantify joint damage in people with rheumatoid arthritis (RA). Damage in the joints of people with RA is currently measured by visual inspection and detailed scoring on radiographic images of small joints in the hands, wrists and feet. Finding an automated way to measure joint damage is important for both clinical research and patient care. While further research and development of computational methods are needed before such tools can be broadly used, the team’s study demonstrates this type of approach is feasible.

HSS Study Identifies Risk Factors for “Long-Haul” COVID-19 in People with Rheumatic Diseases

• Rheumatologists Medha Barbhaiya, MD, MPH, Lisa A. Mandl, MD, MPH, and colleagues investigated risk factors for experiencing “long-haul” COVID-19 in patients with rheumatic diseases, as defined by the loss of taste or smell, muscle aches and difficulty concentrating, for one month or longer. Findings identified long-haul COVID was particularly high for smokers, patients with comorbidities such as asthma or lung disease, cancer, chronic kidney disease, diabetes, congestive heart failure or myocardial infarction, and those taking corticosteroids.

Research Reveals Racial and Ethnic Disparities Persist in Pregnancy Outcomes of Patients with Lupus

• A study including researchers at HSS and led by rheumatologist Bella Mehta, MBBS, MS, MD, revealed pregnancy outcomes in patients with lupus have improved in all racial and ethnic groups over the past decade, however disparities still exist. The researchers used the National Inpatient Sample to conduct a retrospective cross-sectional analysis of lupus and pregnancy related hospital admissions from 2008 to 2017 and evaluated the pregnancy outcomes of four groups: Caucasians, African Americans, Hispanics, and Asians/Native Americans/Others. Outcomes included in-hospital maternal mortality, fetal mortality, non-delivery related admissions and Cesarean section.

HSS Study Sheds Light on Real-World Treatment Patterns of Psoriatic Arthritis

• A study by rheumatologists Monica Schwartzman, MD, MS, and Lisa A. Mandl, MD, MPH, offered real-world clinical practice and patient medication preferences for the treatment of psoriatic arthritis (PsA). Results demonstrated there has been a significant increase in anti-IL17 and anti-phosphodiesterase-4 medications being used as initial treatment for PsA since 2018, which may reflect their inclusion as potential initial therapy in the American College of Rheumatology/National Psoriasis Foundation guidelines, as well as the importance placed by patients on medication side effects (particularly preservation of the joint and function and safety).

New HSS Study Finds Hip Replacements on the Rise Among Adolescents Under 21 Years of Age

• Research by rheumatologist Bella Mehta, MBBS, MS, MD, and colleagues found total hip arthroplasty (THA) procedures are on the rise among adolescents under 21 years of age, however the upswing is not being driven by a rise in the number of children with inflammatory joint disease. Findings suggest that nonsurgical therapies to control these conditions are working.