“We welcome Dr. Askanase to HSS and we are confident that her leadership and vision will help us to advance excellence in clinical care, research, education, and community service through the Department of Medicine and Division of Rheumatology,” said Bryan T. Kelly, MD, MBA, president and CEO and Surgeon-in-Chief Emeritus at HSS. “HSS is also deeply grateful for Dr. Bridges, a highly respected physician-scientist whose leadership and legacy has profoundly advanced patient care and scientific discovery at HSS.” 

Dr. Askanase was selected following a rigorous, nationwide search led by an external executive search firm, which attracted a highly competitive pool of accomplished candidates from leading academic medical centers. She brings more than two decades of leadership in academic rheumatology. From 1999 to 2013, Dr. Askanase practiced at NYU Langone Health and the Hospital for Joint Diseases, where she developed a strong appreciation for the close integration of orthopedics and rheumatology in caring for patients with complex musculoskeletal disease. Since 2014, she has served on the faculty of Columbia University Irving Medical Center, where she is a Professor of Medicine and founded and directs the Columbia Lupus Center. 
“Dr. Askanase is a distinguished and highly respected clinician-scientist who has made significant contributions to the fields of rheumatology and lupus. She approaches complex cases with extraordinary dedication and compassion and is a powerful advocate for populations disproportionately affected by rheumatic diseases,” said Douglas E. Padget, MD, Surgeon-in-Chief and Medical Director at HSS. “Her leadership will be an invaluable addition to our community. Her appointment underscores HSS’s commitment to the advancement of patient care practices by recruiting outstanding physician leaders in our clinical specialties.” 

A globally recognized clinician-scientist, Dr. Askanase has led or participated in more than 150 clinical investigations and has played a significant role in shaping national and international standards for rheumatologic care through leadership positions with the American College of Rheumatology, the Lupus Foundation of America, the Lupus Research Alliance, and the Systemic Lupus International Collaborating Clinics network. She is a clinician, diagnostician, and researcher specializing in complex Systemic Lupus Erythematosus (SLE), more commonly known as lupus. Her research in SLE encompasses epidemiology, outcomes research, and therapeutic clinical trials. Ongoing government-funded projects include the use of optical imaging to evaluate subclinical arthritis, the development of virtual lupus disease activity measures, and lupus education outreach to disparate populations. Dr. Askanase has been at the vanguard of cell therapy research and treatments for SLE and other autoimmune diseases; and she is the Global PI of several novel cell therapy programs and an Investigator Initiated Study to evaluate the safety and efficacy of CAR-NKs. Her work in advancing patient-centered care models, clinical trials in autoimmune disease, and cell therapy initiatives aligns closely with HSS’s commitment to innovation and excellence across the continuum of musculoskeletal care. 

In her role at HSS, Dr. Askanase will provide strategic leadership in Rheumatology while overseeing the Department of Medicine, with a focus on strengthening collaboration across specialties, advancing clinical and translational research, and supporting excellence in patient care, education, and mentorship. 

“I feel privileged to have the opportunity to lead the renowned HSS Division of Rheumatology and Department of Medicine as we continue to advance and transform the science and practice of rheumatology and its related specialties,” said Dr. Askanase. “This is a pivotal moment for our field, with rapid progress in diagnostics, therapeutics, and personalized approaches to care. At HSS, we are uniquely positioned to translate these innovations into meaningful improvements in patients’ lives. Working alongside our esteemed colleagues in Orthopedics, we have an unparalleled opportunity to shape the future of musculoskeletal health worldwide—through clinical excellence, groundbreaking research, and a shared commitment to delivering the highest quality of care.” 
 

U.S. News evaluated nearly 4,500 hospitals in 15 specialties. Hospital performance was assessed based on various measures, including patient outcomes, level of nursing care, patient-reported experience, and available technology such as computer-assisted orthopedic surgery. The methodology factored in data from the Centers for Medicare & Medicaid Services, the American Hospital Association, professional organizations, and medical specialists.

“We are once again honored to be recognized as a leader in our specialties of orthopedics and rheumatology,” said HSS President and CEO Bryan T. Kelly, MD, MBA. “This reflects the skill and dedication of every member of the HSS team, who work together to help people get back to what they need and love to do better than any other place in the world.”

“The U.S. News rankings underscore HSS’s continued leadership and commitment to musculoskeletal health, reflecting 162 years of clinical excellence, innovation, and patient-centered care,” said Douglas E. Padgett, MD, surgeon-in-chief and medical director of HSS. “Our consistent recognition as a top hospital highlights our steadfast dedication to maintaining the highest standards of evidence-based care.”

Patients come to HSS from all 50 states and more than 100 countries, often for complex medical conditions or challenging surgeries requiring highly specialized care.

“When faced with a challenging rheumatologic disease, every patient wants a rheumatologist they can trust,” said S. Louis Bridges, Jr., MD, PhD, physician-in-chief and chief of the Division of Rheumatology at HSS. “The high rating of HSS Rheumatology demonstrates clinical excellence made possible by our strong dedication to best practices and personalized care, and by our commitment to advancing musculoskeletal medicine through research, education, and innovation.”

As the world’s leading academic medical center specializing in musculoskeletal health, HSS maintains among the lowest hospital readmission rates for orthopedics in the nation, and among the lowest rates for infection and complications. HSS has been named No. 1 in the world for orthopedics by Newsweek each year since the “World’s Best Specialized Hospitals” survey was introduced in 2020.

HSS is one of only three US hospitals ranked No. 1 both nationally and globally in any specialty.

In 2024, HSS clinicians and surgeons provided specialized care to more than 248,917 patients with orthopedic or rheumatologic conditions, such as pain or injury to the back, neck, or joints; osteoarthritis; rheumatoid arthritis; lupus; scleroderma; and psoriatic arthritis. HSS performed more than 43,000 orthopedic surgical procedures in 2024.

HSS is the official hospital of and provides team physicians to more than 25 high-performing sports teams and leagues, including the New York Giants, New York Knicks, New York Liberty, Brooklyn Nets, New York Mets, New York Red Bulls, TCS New York City Marathon, National Basketball Players Association, Major League Pickleball, US Youth Soccer, and UFC. It is designated a Medical Center of Excellence by Fédération Internationale de Football Association (FIFA).

* Copyright © 2025 U.S. News & World Report, L.P. Data reprinted with permission from U.S. News.

Dr. Drake has been a consultant in the Division of Endocrinology, Diabetes, Metabolism, and Nutrition at the Mayo Clinic in Rochester, Minnesota since 2007. He assumed a dual role as a consultant in Mayo Clinic’s Division of Hematology in 2017. He has been an Associate Professor of Medicine at the Mayo Clinic College of Medicine and Science since 2015.

Dr. Drake will ensure the continued excellence of the clinical, educational and investigative programs in the Division of Endocrinology and the Metabolic Bone Service. He will work with HSS physicians and staff to optimize quality, the patient experience and outcomes. His role will include collaboration with internists and orthopedic surgeons at HSS, particularly those focused on joint replacement, sports medicine and spine, to identify and address risk factors related to bone health that could affect surgical outcomes.

“Dr. Drake is a world-renowned endocrinologist with clinical and research expertise on age related bone loss, and we enthusiastically welcome him to HSS,” said S. Louis Bridges, Jr., MD, PhD, physician-in-chief and chair of the Department of Medicine at HSS. “His impressive background and considerable experience are vital assets that will enable us to maintain our role as a leader in the diagnosis, treatment and research in endocrine and metabolic bone diseases.”

“With its outstanding reputation for providing the highest standards of care, passion for excellence and innovation, and strong commitment to improving the lives of patients everywhere, it is an honor and a privilege to join HSS,” said Dr. Drake. “I look forward to working closely with the clinical and research staff and collaborating with a highly motivated team of specialized faculty to achieve our best musculoskeletal health outcomes.”

The recipient of numerous research grants from the National Institutes of Health, Dr. Drake will play a key role in the internationally recognized research programs at HSS, collaborating with leaders of the HSS Research Institute, the Department of Orthopedics and the Division of Rheumatology, to define priorities for investigation.

Dr. Drake’s own research has focused on the underlying mechanisms and skeletal changes related to age-related bone loss. He has also sought to better understand how cancer affects bone health. Dr. Drake believes that unraveling the mysteries of how normal aging or the presence of malignancies leads to the softening or destruction of bone mass could ultimately lead to new or improved methods to prevent and treat bone loss.

Dr. Drake’s dedication to his field includes a long list of professional activities. He has served as an independent content reviewer on the Task Force on Cell-Based Therapies for the American Society for Bone and Mineral Research (ASMBR); as a member of the Task Force on Managing Osteoporosis Patients after Long-Term Bisphosphonate Treatment for the ASBMR; and on the scientific advisory boards of the Rare Bone Disease Alliance, Fibrous Dysplasia Foundation, and the Soft Bones Foundation.

His research has been featured in 125 peer-reviewed articles, and he has written 11 book chapters on topics that include the pathogenesis of osteoporosis, myeloma bone disease, and disorders of calcium and bone metabolism.

Dr. Drake graduated Magna Cum Laude from Harvard College, where he received an AB degree in Biology. He attended Washington University earning his MD degree in addition to a PhD in Molecular and Cell Biology. He went on to an Internal Medicine/Endocrinology residency at Duke University Medical Center, where he also completed a clinical research fellowship. His academic accomplishments include a second clinical research fellowship in Endocrinology at the Mayo Clinic College of Medicine.

“The advancement of patient care practices at HSS is demonstrated through our commitment to recruiting outstanding physician leaders in our clinical specialties,” said Douglas E. Padgett, MD, surgeon-in-chief and medical director at HSS. “Drs. Drake’s and Stein’s dedication and expertise in the field of endocrinology demonstrates our relentless focus on high-quality and high-value healthcare for our patients.”

The study, presented today at the annual meeting of the American College of Rheumatology, ACR Convergence 2024, was led by researchers at the University of Colorado School of Medicine in collaboration with investigators from HSS and other centers within the Accelerating Medicines Partnership® Program: Rheumatoid Arthritis and Systemic Lupus Erythematosus (AMP® RA/SLE) Network.¹

“These research findings validate the importance of certain immune cells in the development of RA, particularly in how they drive the change from asymptomatic to symptomatic,” said Laura Donlin, PhD, scientist and co-director of the HSS Precision Medicine Program and co-principal investigator of the National Institutes of Health-supported AMP Rheumatoid Arthritis research consortium. “We hope that one day we can use these insights to stop RA before it even begins.”

Rheumatoid arthritis is a type of inflammatory arthritis that can occur when specific types of immune cells attack the body’s healthy tissues, resulting in pain, swelling and stiffness in joints. It can also result in problems in other areas of the body, such as the heart, lungs, eyes, nerves and skin. Diagnosis typically relies on an evaluation by a rheumatologist for clinical signs and symptoms supported by further evidence from X-rays and blood tests.

For the study, the participating rheumatologists collected tissue and blood samples from patients who either had RA or were considered at risk due to specific antibodies, called ACPA, in their blood and having a first-degree relative with the disease. Researchers at the Broad Institute of MIT and Harvard then used advanced single-cell sequencing techniques to analyze the samples and compared the results to those from healthy individuals.

The analysis found higher numbers of certain immune cells in the patients at risk for RA, including CCR2+ T helper cells, T peripheral helper cells, type 1 T helper cells, and granzyme B-positive memory T helper cells. Advanced sequencing also gave the investigators a better understanding of which genes were activated in these cells, offering insight into how the immune cells in patients with RA differ from those in at-risk individuals and healthy people.

“We knew that the presence of ACPA in blood and having a first-degree relative with rheumatoid arthritis indicate risk, but this new research has allowed us to learn more about the underlying biology driving increased risk,” said HSS rheumatologist Susan M. Goodman, MD, a co-author of the study. “These insights will pave the way toward helping us develop a new tool for determining which patients may benefit from early intervention.”

“There is some evidence that existing RA drugs, such as abatacept or rituximab, may help prevent the disease, but they are relatively expensive and come with side effects,” said co-author S. Louis Bridges, Jr., MD, PhD, physician-in-chief and chief of the Division of Rheumatology at HSS. “Pending validation in larger studies, the new patterns of immune cells identified in this research could represent potential targets for the development of new, more effective therapies.”

HSS Authors: S. Louis Bridges, Jr., MD, PhD, Vivian P. Bykerk, BSc, MD, FRCPC, Susan M. Goodman, MD, Laura Donlin, PhD.

Reference:

¹ Inamo J, Keegan J, Griffith A, Ghosh T, Horisberger A, Howard K, Pulford J, Murzin E, Hancock B, Eisenhaure T, Dominguez S, Gurra M, Gurajala S, Jonsson A, Seifert J, Feser M, Norris J, Cao Y, Apruzzese W, Bridges S, Bykerk V, Goodman S, Donlin L, Firestein G, Bathon J, Hughes L, Tabechian D, Filer A, Pitzalis C, Anolik J, Moreland L, Hacohen N, Guthridge J, James J, Cuda C, Perlman H, Brenner M, Raychaudhuri S, Sparks J, Holers M, Deane K, Lederer J, Rao D, Zhang F. Deciphering Pathogenic Phenotypes by Multi-modal Deep Single-cell Blood Immunophenotyping in Individuals At-risk for Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/deciphering-pathogenic-phenotypes-by-multi-modal-deep-single-cell-blood-immunophenotyping-in-individuals-at-risk-for-rheumatoid-arthritis/. Accessed October 10, 2024.

The study published August 29 in Nature Communications shows that artificial intelligence and machine learning technologies can effectively and efficiently subtype pathology samples from patients with RA.

For this study, Dr. Richard Bell, an Instructor in the HSS Research Institute and Arthritis and Tissue Degeneration Program, and Lionel B. Ivashkiv,  MD, Chief Scientific Officer at HSS teamed up with  Dr. Fei Wang, a professor of population health sciences and the founding director of the Institute of AI for Digital Health (AIDH) in the Department of Population Health Sciences at Weill Cornell Medicine. 

“Our study addresses the analytical bottleneck of pathology research,” Dr. Bell said. “It is very time-consuming and tedious.” “Our tool automates the analysis of pathology slides, which may one day lead to more precise and efficient disease diagnosis and personalized treatment for RA,” said Dr. Wang. “It shows that machine learning can potentially transform pathological assessment of many diseases.”

There are several existing machine learning tools for automatic analysis of pathology slides in oncology. Dr. Wang and his colleagues have been working to expand the use of this technology in other clinical specialties.

Digital Pathology and Precision Medicine in RA

Distinguishing between the three subtypes of RA may help clinicians choose which therapy is most likely to be effective for a particular patient. This personalized medicine approach would represent a breakthrough in the care of patients with RA, and is a major goal of the Research Institute and Division of Rheumatology at HSS, which involves multiple laboratory and clinical investigators. “It’s the first step towards more personalized RA care,” Dr. Bell said. “If you can build an algorithm that identifies a patient’s subtype, you’ll be able to get patients the treatments they need more quickly.”

 The technology may provide new insights into the disease by detecting unexpected tissue changes that humans might miss. By saving pathologists time on subtyping, the tool may also decrease the cost and increase the efficiency of clinical trials testing treatments for patients with different subtypes of RA. “This work represents an important advance in analyzing RA tissues that can be applied for the benefit of patients” Dr. Ivashkiv said.

 Pathologists currently manually classify arthritis subtypes using a rubric to identify cell and tissue characteristics in biopsy samples from human patients—a slow process that adds to the cost of research and may lead to inconsistencies between pathologists.

 The team first trained its algorithm on RA samples from one set of preclinical models, optimizing its ability to distinguish tissue and cell types in the sample and sort them by subtype. They validated the tool on a second set of samples. The tool also yielded new insights into treatment effects in the models, such as reduced cartilage degradation within six weeks of administering commonly used RA treatments.

Then, they deployed the tool on patient biopsy samples from the NIH-supported Accelerating Medicines Partnership Rheumatoid Arthritis research consortium, of which HSS is a major participating site in research led by Laura Donlin, PhD, scientist and co-director of the HSS Precision Medicine Program and rheumatologist Susan  M. Goodman, MD. The new digital pathology approach could effectively and efficiently type human clinical samples. The researchers are now validating the tool with additional patient samples and determining the best way to incorporate this new tool into pathologists’ workflows.

 The team is working to develop similar tools for evaluating osteoarthritis, disc degeneration and tendinopathy.

The research reported in this story was supported in part by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute of Allergy and Infectious Diseases, the National Institute of General Medical Sciences, and the National Institute on Aging, all part of the National Institutes of Health, through grant numbers R21AR071670, R01AI175212, UH2AR067690, UC2AR081025, F30AG076326, T32GM007356, AR046713, AR050401, R01AR078268, UC2AR081025, UL1TR001866 and R01AR056702.

U.S. News evaluated nearly 5,000 hospitals in 15 specialties. Hospital performance was assessed based on various measures, including patient outcomes, level of nursing care, patient-reported experience, and available technology such as computer-assisted orthopedic surgery. The methodology factored in data from the Centers for Medicare & Medicaid Services, the American Hospital Association, professional organizations, and medical specialists.

“This recognition reflects 161 years of specialization and the skill and dedication of thousands of HSS colleagues who provide or support care for our patients,” said Bryan T. Kelly, MD, MBA, HSS president, CEO and surgeon-in-chief emeritus. “HSS is a place that inspires and empowers extraordinary people to seek and solve challenges big and small to make HSS and our patients better every day.”

Patients come to HSS from all 50 states and more than 100 countries.

“Whether for a rheumatology consultation or a highly complex surgery, choosing a healthcare provider is one of the most important decisions an individual can make,” said Douglas E. Padgett, MD, surgeon-in-chief and medical director of HSS. “The U.S. News rankings are a testament to our success in providing the highest quality care for patients who trust HSS. As our institution grows to offer services to more people, we will continue to provide evidence-based, personalized care to achieve the best outcomes.” 

“The U.S. News rankings highlight the recognition of excellence in rheumatology at HSS and emphasize the importance of specialized expertise in the diagnosis and treatment of rheumatic diseases,” said S. Louis Bridges, Jr., MD, PhD, physician-in-chief and chief of the Division of Rheumatology. “Accurate, prompt diagnosis of these often-challenging diseases remains the cornerstone of successful treatment. Many rheumatologists at HSS focus on specific rheumatic conditions, which leads to better patient outcomes. Our clinicians work closely with HSS researchers to enhance our understanding of rheumatic diseases and develop innovative treatment approaches to benefit patients worldwide.”

HSS is the world’s leading academic medical center specializing in musculoskeletal health and the only hospital in North America designated by the World Economic Forum to serve in the Global Coalition for Value in Healthcare. HSS maintains the nation’s lowest hospital readmission rates for orthopedics and among the lowest infection and complication rates. HSS has been named No. 1 in the world for orthopedics by Newsweek each year since introducing its “world’s best hospitals” survey in 2020.

In 2023, HSS clinicians and surgeons provided specialized care to more than 211,000 patients with orthopedic or rheumatologic conditions, such as pain or injury to the back, neck, or joints; osteoarthritis; rheumatoid arthritis; lupus; scleroderma; and psoriatic arthritis. HSS performed more than 41,000 orthopedic surgical procedures in 2023.

HSS is the official hospital of and provides team physicians to more than 20 high performing sports teams and leagues, including the New York Giants, New York Knicks, New York Liberty, Brooklyn Nets, New York Mets, New York Red Bulls, New York Road Runners, National Basketball Players Association, Major League Pickleball, US Youth Soccer, and UFC. It is designated a Medical Center of Excellence by Fédération Internationale de Football Association (FIFA).

* Copyright © 2024 U.S. News & World Report, L.P. Data reprinted with permission from U.S. News.

Drs. Kelly, Padgett, Allen, and Bostrom will work within a new leadership structure, together with Physician-in-Chief S. Louis Bridges, MD, PhD, to support and ensure the highest standards in patient care, research, education,innovation, compliance, and quality control are upheld as HSS expands. Additionally, they will identify and support emerging initiatives focused on injury prevention, non-surgical and surgical care.

"Leading the world’s greatest concentration of medical talent in our field at this moment of unprecedented need and opportunity is a special responsibility and privilege," said Dr. Kelly. "Under Dr. Padgett’s leadership, Dr. Allen and Dr. Bostrom will help ensure HSS remains the best place in the world for patients to receive the care we provide, and the best place in the world for the most gifted medical providers to realize their potential."  

Specialized in orthopedics, rheumatology and related disciplines since 1863, HSS is today a world leader in research, innovation, and education.  It has been ranked no. 1 in orthopedics worldwide by Newsweek for the past three years, and nationwide by U.S. News & World Report for the past 14 years. US News & World Report also ranks HSS no. 2 in the nation for Rheumatology and a Best Hospital for Pediatric Orthopedics. 

In 2022, HSS provided care to 200,000 patients from all 50 states and 80 countries and performed more than 38,000 surgical procedures.  It provides continuing clinical education to more than 27,000 medical specialists in 165 countries.

"The success of an organization is connected to the strength and values of its leadership,” said Dr. Padgett, who was appointed the first Associate Surgeon-in-Chief and Deputy Medical Director at HSS in 2019. “I am honored to work alongside Answorth and Mathias, who are uniquely qualified to help further our mission and ensure we continue to provide the highest quality musculoskeletal care to all our patients.” 

Answorth A. Allen, MD

Dr. Allen, the medical director for HSS West Side, is a sports medicine orthopedic surgeon specializing in shoulder, knee, and elbow surgery, as well as a Professor of Clinical Orthopedic Surgery at Weill Cornell Medical College (WCMC). He earned his medical degree from WCMC, completed residency programs at The New York Orthopaedic Hospital and Columbia Presbyterian Medical Center and did a fellowship at the University of Pittsburgh. He has authored over 150 peer-reviewed articles and book chapters on shoulder, knee, and elbow conditions.

“I am honored to be joining the medical leadership team at HSS, which is committed to delivering best-in-class healthcare experiences,” said Dr. Allen. “HSS has and will continue to grow exponentially, and I look forward to assisting in the next phase of advancement and excellence.” Dr. Allen will succeed Dr. Padgett as Deputy Medical Director.  

Dr. Allen is the team orthopedist for the New York Knicks professional men’s basketball team and an orthopedic consultant for the West Indies Cricket Board of Control. Previously, he has served as an assistant team physician for both the New York Saints lacrosse team and the New York State Racing Association; a staff physician for the New York State Athletic Commission and the Hunter Mountain Ski Sports Center; and an assistant team physician for the University of Pittsburgh and assistant company physician for the Pittsburgh Ballet Theatre.

Mathias P. Bostrom, MD

In 2019, Dr. Bostrom was appointed chief of adult reconstruction and joint replacement at HSS, succeeding Dr. Padgett. He has authored over 200 peer-reviewed publications, been the principal investigator of NIH-funded research, and served as director of HSS Education and Academic Affairs since 2003. He has led the HSS Fellowship Program from 2002 to 2019 and its nationally top-ranked Residency Program from 2005 to 2019 and served as chief of the HSS Hip Service from 2014 to 2019.

“HSS is known for providing comprehensive and collaborative care to all our patients, and I am committed to building upon that legacy,” said Dr. Bostrom, who in addition to becoming Associate Surgeon-in-Chief will be appointed Director of Quality and Safety. “I am also grateful for this leadership opportunity, and I am excited to work alongside talented and remarkable teams to advance the field of musculoskeletal health.”

Dr. Bostrom specializes in hip and knee surgery, including complex reconstructions and treatment of musculoskeletal infections. A graduate of the University of Virginia and Johns Hopkins, he completed his residency and two fellowships at HSS before joining the faculty in 1996. Dr. Bostrom currently practices at the HSS main campus in New York City and sees patients at HSS Westchester. Dr. Bostrom is a member of the Hip Society, the Orthopaedic Research Society, and the International Society for Fracture Repair.

Drs. Allen and Bostrom will assume their new roles in the HSS Office of Medical Leadership on September 5, 2023.

“The leadership team have demonstrated outstanding stewardship qualities, and their concentration in executing key health and operational initiatives will continue to advance HSS as a recognized global leader in the healthcare market,” said Shapiro. “It’s an exciting time at HSS as leadership advances our Purpose: to help people get back to what they need and love to do, better than any other place in the world.”

U.S. News evaluated more than 4,500 hospitals in 15 specialties. Hospital performance was assessed using a variety of measures, including outcomes, level of nursing care, patient experience, and available technology such as computer-assisted orthopedic surgery, according to U.S. News. The methodology factored in data from the Centers for Medicare & Medicaid Services, American Hospital Association, professional organizations, and medical specialists.

“This U.S. News analysis validates that we are providing the highest quality care in fields that are advancing steadily,” said HSS CEO Louis A. Shapiro. “We remain at the top by setting a higher standard for ourselves in every aspect of what we do, from patient care to quality to culture and beyond. Every single member of the HSS team plays a vital role.”

HSS is the world’s leading academic medical center specialized in musculoskeletal health, and the only hospital in North America designated by the World Economic Forum to serve in the Global Coalition for Value in Healthcare. HSS maintains the lowest readmission rates for orthopedics in the nation, and among the lowest rates for infections and complications.

"Our 160 years of focus on musculoskeletal conditions is a distinguishing feature of HSS, enabling us to provide highly specialized care that benefits our patients and leads to the most reliably superior outcomes," said Bryan T. Kelly, MD, MBA, president, surgeon-in-chief and medical director of HSS. “The high rankings reflect our special expertise, our strong dedication to evidence-based medicine, our constant focus on safety, and our steadfast commitment to research and innovation to advance the field of musculoskeletal care.” 

“Individuals with rheumatic diseases face many challenges and we are committed to providing the most advanced, personalized and compassionate care for each of our patients,” said S. Louis Bridges, Jr., MD, PhD, physician-in-chief and chief of the Division of Rheumatology at HSS. "We are proud to be recognized for excellence by U.S. News and will continue to work as a team to maintain the highest standards of care and improve our patients’ lives.”

In 2022, HSS clinicians provided specialized care to more than 200,000 patients for all types of orthopedic and rheumatologic conditions, such as pain or injury to the back, neck or joints, osteoarthritis, rheumatoid arthritis, lupus, scleroderma, and psoriatic arthritis. Over the course of the year HSS performed more than 38,000 orthopedic surgical procedures.

HSS is the Official Hospital and provides Team Physicians to more than 20 high performing sports teams and leagues including Major League Pickleball, the New York Giants, New York Knicks, Brooklyn Nets, New York Liberty, New York Mets, New York Red Bulls, New York Road Runners, National Basketball Players Association, US Youth Soccer, and UFC. It is designated a Medical Center of Excellence by Fédération Internationale de Football Association (FIFA).

* Copyright © 2023 U.S. News & World Report, L.P. Data reprinted with permission from U.S. News.

Michael Lockshin, MD, received the ACR Distinguished Clinician Scholar Award, which honors a rheumatologist who has made outstanding contributions in clinical medicine, clinical scholarship or education.

Melanie Smith, MD, PhD, received the ACR Distinguished Fellow Award, which recognizes clinical and research fellows who are in a rheumatology fellowship training program and have performed meritoriously.

Adena Batterman, LCSW, MSW, received the ARP Distinguished Clinician Award. It is presented to an ARP member who is engaged in clinical practice and demonstrates outstanding clinical expertise in arthritis and the rheumatic diseases.

"HSS is extremely proud of our team members who have been honored with these notable awards,” said Louis A. Shapiro, president and CEO of HSS. “We warmly congratulate them for their contributions and achievements in patient care, research, support and education.”

Michael Lockshin, MD

Dr. Lockshin’s award follows a career spanning more than four decades at HSS. When asked about receiving the honor, he said, “I think it honors those who surrounded and challenged me more than it does me—patients who asked hard questions; the team led by Charles Christian that trained me and with whom I was privileged to work; intellectually curious colleagues, students and fellows; Hospital for Special Surgery, which gave me freedom to pursue goals I thought were worthwhile; and my wonderful family.”

Director emeritus of the Barbara Volcker Center for Women and Rheumatic Disease at HSS, Dr. Lockshin is a preeminent expert in the long-term care of chronically ill patients. His research enabled him to develop special expertise in solving health-care issues associated with systemic lupus erythematosus, antiphospholipid antibody syndrome and other autoimmune diseases that predominantly affect women.

Dr. Lockshin continues to conduct research and engage in mentoring activities at HSS. His current work focuses on diagnostic uncertainty, the topic of an international conference he organized last year. He has also published a white paper and written a book on the subject.

Melanie Smith, MD, PhD

Dr. Smith describes her Distinguished Fellow award as an incredible honor. “It is a testament to the opportunities I have had during my fellowship training and the amazing group of mentors that have supported my development as both a physician and a scientist,” she said. “I am excited to embark on a career dedicated to understanding mechanisms of disease with the goal of improving care for our patients.”

Dr. Smith, now a staff rheumatologist at HSS, specializes in treating inflammatory arthritic conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Sjogren's syndrome and gout/pseudogout. She also treats patients with osteoarthritis. Her research focuses on how cells that make up the healthy joint lining change when an individual develops rheumatoid arthritis.

Adena Batterman, LCSW, MSW

Adena Batterman, recognized with the ARP Distinguished Clinician Award, is senior manager of the Inflammatory Arthritis Support and Education Programs at HSS. “I feel honored and grateful to be recognized for clinical work and research that enhances the lives, and elevates the voices, of patients,” she said. “I’m grateful to be engaged in work made possible by colleagues and mentors that continues to have deep personal and professional meaning to me.”

Ms. Batterman develops and oversees support and education programs designed to address the multifaceted needs of patients with inflammatory arthritis during the many stages of their illness. The programs provide essential information to help participants make informed decisions about management and treatment; offer peer support and coping strategies; and create a forum in which members can share their experiences and feelings.

“I commend our HSS colleagues who have been honored by two of the foremost organizations advancing the field of rheumatology,” said S. Louis Bridges, Jr., MD, PhD, physician-in-chief and chief of the Division of Rheumatology at HSS. "Our colleagues’ hard work, skill and dedication have enabled them to excel in their respective specialties. Their contributions have helped HSS achieve a leadership role in rheumatology to improve the lives of patients with exceptional care and vital research.”  

This is the 13^th consecutive year in a row that HSS has attained the top position nationally in orthopedics. Its No. 3 spot in rheumatology nationwide is the highest ranking for the specialty in the Northeast. This follows the U.S. News Best Children’s Hospitals© rankings announced last month, in which HSS surged into the Top 10 nationally and was highest ranked in NY, NJ and CT for Pediatric Orthopedics.

"When faced with musculoskeletal conditions or complex surgery, choosing a hospital is one of the most important decisions one will ever make,” said Louis A. Shapiro, president and CEO of HSS. “Our rankings in orthopedics and rheumatology by U.S. News are not only a great honor but a testament to each staff member’s commitment to do their best — and to improve on their best every day. The result is the highest-quality care for every patient who places their trust in HSS.”

For the 2022-2023 rankings, U.S. News evaluated more than 4,500 hospitals in 15 specialties using a variety of measures, ranging from outcomes, level of nursing care, and patient experience to the availability of technology such as computer-assisted orthopedic surgery. The methodology also factored in data from the Centers for Medicare & Medicaid Services, American Hospital Association, professional organizations, and medical specialists.

According to the survey, HSS outperformed in back surgery and spinal fusion, hip fracture, hip replacement and knee replacement.

“Our extraordinary focus on musculoskeletal conditions enables us to provide highly specialized, patient-centered care to help people get back to what they need and love to do,” said Bryan T. Kelly, MD, MBA, surgeon-in-chief and medical director at HSS. “A combination of factors has enabled HSS to achieve outstanding outcomes: the highest standards in patient care and safety; our dedication to evidence-based medicine, including advances in technology; our seminal research in the treatment of musculoskeletal conditions; and our commitment to training the physicians, surgeons and investigators who will help shape the future of musculoskeletal care.”  

“We are proud to be recognized by U.S. News for outstanding care,” said S. Louis Bridges, Jr., MD, PhD, physician-in-chief and chief of the Division of Rheumatology at HSS, noting the significant growth of rheumatology at HSS to meet the increasing demand for its services. “We will continue to respond to changes and challenges in health care by embracing an integrative care approach that addresses the needs of the whole person. Our goal is to improve our patients’ lives with innovative, evidence-based treatments and dedicated research to advance the field.”

In 2021, HSS surgical teams performed 36,870 orthopedic procedures; HSS clinicians provided nearly 446,000 nonsurgical consultations for conditions including joint pain, trauma and sports injuries, osteoarthritis, rheumatoid arthritis, back pain, spinal disorders, and conditions of the hand, upper extremities, foot and ankle.

HSS provides care to the highest-performing professional, collegiate and amateur athletes and organizations around the world, including USA Basketball, Fédération Internationale de Football Association (FIFA), UFC, the Brooklyn Nets, the New York Giants, the New York Knicks, the New York Mets and the New York Red Bulls, among others.

* Copyright © 2022 U.S. News & World Report, L.P. Data reprinted with permission from U.S. News.

The studies focus on the tapering of treatment in patients whose disease is well controlled, real-world outcomes for targeted therapies, assessing the effects of biologic treatments on immune cells from patients with RA, and the underlying mechanisms of arthritis triggered by immune checkpoint therapies used to treat cancer.

What follows are some highlights from the meeting:

Effectiveness of Upadacitinib in the Treatment of Rheumatoid Arthritis: Analysis of 6-Month Real-World Data from the United Rheumatology Normalized Integrated Community Evidence (UR-NICETM) Database

Upadacitinib, an oral Janus kinase (JAK) inhibitor, was approved for the treatment of RA in 2019 after clinical trials suggested that it reduced symptoms and had acceptable side effects. But since that time, few real-world data have been reported on how patients respond to upadacitinib outside of clinical trials. This six-month study looked at outcomes for 140 patients receiving upadacitinib alone and 223 receiving upadacitinib plus conventional synthetic disease-modifying antirheumatic drugs (DMARDs). The investigators, led by HSS rheumatologist Allan Gibofsky MD, JD, MACR, FACP, FCLM, found that overall 46% of patients receiving upadacitinib achieved low disease activity and 14% achieved remission, with better results for patients in the combination therapy group than those who got upadacitinib alone. The effectiveness of upadacitinib was not impacted by prior therapy with a tumor necrosis factor inhibitor or tofacitinib. This study supported the use of upadacitinib in clinical practice, including in patients with prior exposure to advanced therapy.

Authors: Allan Gibofsky, MD, JD, MACR, FACP, FCLM (HSS), Mark E. Pearson, MD (West Suburban Center for Arthritis), Andrew Concoff, MD (United Rheumatology), Anna Shmagel, MD, Patrick Zueger, PhD, Yanna Song, MS, Lauren D. Smith, MD (AbbVie Inc.), Grace C. Wright, MD, PhD (Grace C. Wright MD PC, Association of Women in Rheumatology).

Can Patients with Controlled RA Receiving Any Class of Targeted Therapy with Methotrexate (MTX) Sustain Disease Control after Tapering MTX? A Systematic Review and Meta-Analysis 

People with RA frequently wish to taper the use of methotrexate therapy due to its side effects, but there are questions about the best way to do that. Guidelines that recommend tapering methotrexate before tapering biologic DMARDs are not based on direct evidence. In this study, a team of HSS investigators led by rheumatologist Charis F. Meng, MD, and Director of the Inflammatory Arthritis Center Vivian P. Bykerk, MD, FRCPC, conducted a literature search to look at whether patients who are taking the combination of methotrexate and targeted therapy (biologic therapies and JAK-inhibitors) can taper methotrexate and still be in remission from their RA, while continuing their targeted therapies. They identified 10 studies that met their inclusion criteria. These studies included a number of different targeted therapies. Based on their analysis, the team concluded that patients with controlled RA have a high probability of maintaining disease control for at least 18 months after tapering their methotrexate and continuing targeted therapies. They noted that this review may inform patients who are experiencing controlled disease while taking methotrexate in combination with any of a range of targeted therapies and who are struggling with methotrexate-related side effects. However, they concluded longer follow-up studies are needed to confirm the disease will not worsen over time and that patients should be told about this possibility.

Authors: Charis F. Meng, MD, Diviya Rajesh, Deanna Jannat-Khah, DrPH, Omar Bruce, MPH, Bridget Jivanelli, MLIS, Vivian P. Bykerk, BSc, MD, FRCPC (HSS).

Differential Pharmacodynamic Alterations After Treatment with Abatacept or Adalimumab in MTX-Inadequate Responder Patients with Early RA: Whole Blood RNA-Seq Analysis of the Early AMPLE Study

A number of novel agents for RA are now available for treatment, but tools to predict which patients are likely to respond to specific drugs are lacking. To ensure that patients are matched with the best treatment, more research is needed to determine the molecular signatures of these drugs and their mechanisms of action. In this study, part of a Phase 4 trial called Early AMPLE, investigators including HSS Physician-in-Chief and Chair of the Department of Medicine S. Louis Bridges, Jr., MD, PhD, and Director of the Inflammatory Arthritis Center Vivian P. Bykerk, MD, FRCPC, looked at pharmacodynamic changes in patients in response to treatment with either abatacept or adalimumab. The aim was to identify and differentiate the impact of each drug on modulation of immune cells at the molecular level. The investigators performed pharmacodynamic and other analyses for 14,540 protein-coding genes in 664 RNA- Seq samples, with materials collected from 79 patients with RA who were predicted to respond better to abatacept. They found that after treatment, twice as many genes and pathways were significantly altered in the adalimumab arm versus the abatacept arm and that abatacept treatment decreased immune cell cycle gene expression while adalimumab treatment increased expression of these genes. The differential gene expression was seen in genes known to correlate with RA disease activity. The investigators concluded that these findings may explain the greater clinical improvements seen with abatacept versus adalimumab. Because patients in the Early AMPLE study were predicted to respond differentially to abatacept, these findings may be relevant only to this subgroup of patients. These findings warrant further studies to investigate the potential positive correlation between RA-relevant effects and better therapeutic outcomes.

Authors: Chun Wu (Bristol Myers Squibb), Yicong Li (Parexel International), Neelanjana Ray, Michael A. Maldonado, Peter Schafer (Bristol Myers Squibb), S. Louis Bridges, Jr., MD, PhD (HSS), William Rigby (Dartmouth-Hitchcock Medical Center), Vivian P. Bykerk, MD, FRCPC (HSS), Jane Buckner (Benaroya Research Institute at Virginia Mason), Jinqi Liu (Bristol Myers Squibb).

The Probability of Sustaining Rheumatoid Arthritis Remission in Patients Tapering Targeted Therapy Used as Monotherapy: a Systematic Review and Meta-Analysis 

A second study led by HSS rheumatologist Charis F. Meng, MD, and Director of the Inflammatory Arthritis Center Vivian P. Bykerk, MD, FRCPC, also used a literature review to look at the effects of tapering drugs for RA in people whose disease is well controlled. This study focused on patients receiving either biologic DMARDs or JAK inhibitors being used alone. A search resulted in five studies that compared tapering of targeted monotherapy (TNF-i, tocilizumab, abatacept, or baricitinib) with continuing therapy or other tapering regimens. A meta-analysis including data from 800 patients found a trend for lower odds of disease remission with targeted therapies versus comparator treatment regimens, but these data were not conclusive. The investigators noted that the lack of trials designed to compare tapering targeted monotherapy to continuing it led to a significant gap in knowledge in an area of research that is increasingly relevant for patients. Their review suggests that stopping targeted monotherapy is unlikely to maintain disease control, but that more gradual tapering schemes, dose reduction, and early treatment of disease may be associated with more successful tapering. More studies are needed to better inform patients, and it is not recommended to stop targeted monotherapy in RA based on this analysis.

Authors: Charis F. Meng, MD, Diviya Rajesh, Deanna Jannat-Khah, DrPH, Omar Bruce, MPH, Bridget Jivanelli, MLIS, Vivian P. Bykerk, MD, FRCPC (HSS).

Less ACPA Epitope Expansion Is Found in ACPA-Positive Immune Checkpoint Inhibitor Arthritis Patients Compared to ACPA-Positive Rheumatoid Arthritis Patients

Immune checkpoint inhibitors (ICI) have improved the treatment of many advanced cancers. However, they can lead to immune-related adverse events, including treatment-induced arthritis. This form of arthritis is similar to RA. About 9% of people with this condition test positive for the anti-citrullinated peptide antibody (ACPA). In RA, the increase in ACPA occurs over the years prior to onset of clinical disease. In this study, led by HSS rheumatologist Nilasha Ghosh, MD, MS, investigators examined the degree of ACPA epitope expansion in patients receiving ICI to determine whether treatment-induced arthritis is similar to early RA, or more suggestive of the pre-clinical phase of disease. The analysis employed clinical data and serum samples from 12 patients with ICI arthritis (ICI-A) as well as from 39 ACPA-positive RA patients. There were a number of differences between the patients in the two groups, including age and smoking history. The investigators reported that, overall, people with ICI-A had lower ACPA titers and targeted fewer ACPA epitopes than people with early RA, suggesting that ICI-A may represent an accelerated model of RA pathogenesis with ICI triggering an early transition from pre-clinical to clinical disease. They noted that sequential sampling and analysis are warranted to further determine how the pathogenesis of ICI-A relates to that of RA.

Authors: Diviya Rajesh, Nilasha Ghosh, MD, MS (HSS), Jessica Kirschmann (Stanford University), Karmela Kim Chan, MD, Deanna Jannat-Khah, Susan M. Goodman, MD, Vivian P. Bykerk, BSc, MD, FRCPC (HSS), William Robinson, MD, PhD (Stanford University), Anne R. Bass, MD (HSS).

Dr. Niewold is currently the Editor-in-Chief of the Journal of Immunological Methods, serves on the Board of Directors of the Lupus Research Foundation and the Sjögren’s Syndrome Foundation, and is a standing member of the U.S. Department of Defense’s Peer Reviewed Medical Research Program. He has recently served as a standing member of the National Institutes of Health (NIH) Arthritis, Connective Tissue, and Skin (ACTS) Study Section. He is a former Chair of the Scientific Advisory Council of the Rheumatology Research Foundation, and a past President of the Central Society for Clinical and Translational Research.

“We are delighted that Dr. Niewold will help lead the next generation of groundbreaking translational and clinical research for the Department of Medicine at HSS,” said S. Louis Bridges, Jr., MD, PhD, physician-in-chief and chair of the Department of Medicine at HSS. “We are at a historic intersection of knowledge, cutting edge technology and patient need. We are poised to accelerate impactful patient oriented research that will improve the lives of our patients.”

Dr. Niewold returns to HSS from the New York University Grossman School of Medicine, where he served as Judith and Stewart Colton Professor of Medicine and Director of the Colton Center for Autoimmunity.

Dr. Niewold, a world leader in lupus research, moves to HSS together with outstanding rheumatology investigators Theresa Wampler Muskardin, MD; Ruth Fernandez-Ruiz, MD; and Ashira Blazer, MD. At HSS Dr. Niewold and his colleagues will continue their current research, including three studies supported by the NIH, and one supported by the Centers for Disease Control and Prevention (CDC).

“Research is foundational to HSS excellence, and scientific leadership in rheumatic diseases is among the ways we achieve reliably better outcomes for patients with any musculoskeletal condition,” said Bryan T. Kelly, MD, MBA, HSS surgeon-in-chief and medical director. “Dr. Niewold and I both had the privilege of training at HSS, and I’m very happy to now share with him also the privilege of leading HSS to improve quality of life for future generations.”

“HSS has the privilege and responsibility to help people get back to what they need and love to do better than any other place in the world,” added HSS President & CEO Louis A. Shapiro. “Since our founding 158 years ago, that begins and ends with the most talented, most committed specialists, and so we are especially pleased to welcome Dr. Niewold home and support his leadership forward.”

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. This includes both joint space narrowing (which indicates cartilage loss) and bone erosions (which indicates damage from invasion of the inflamed joint lining). The scoring system requires specially trained experts and is time-consuming and expensive. Finding an automated way to measure joint damage is important for both clinical research and for care of patients, according to the study’s senior author, S. Louis Bridges, Jr., MD, PhD, physician-in-chief and chair of the Department of Medicine at HSS.

“If a machine-learning approach could provide a quick, accurate quantitative score estimating the degree of joint damage in hands and feet, it would greatly help clinical research,” he said. “For example, researchers could analyze data from electronic health records and from genetic and other research assays to find biomarkers associated with progressive damage. Having to score all the images by visual inspection ourselves would be tedious, and outsourcing it is cost prohibitive.”

“This approach could also aid rheumatologists by quickly assessing whether there is progression of damage over time, which would prompt a change in treatment to prevent further damage,” he added. “This is really important in geographic areas where expert musculoskeletal radiologists are not available.”

For the challenge, Dr. Bridges and his collaborators partnered with Sage Bionetworks, a nonprofit organization that helps investigators create DREAM (Dialogue on Reverse Engineering Assessment and Methods) Challenges. These competitions are focused on the development of innovative artificial intelligence-based tools in the life sciences. The investigators sent out a call for submissions, with grant money providing prizes for the winning teams. Competitors were from a variety of fields, including computer scientists, computational biologists and physician-scientists; none were radiologists with expertise or training in reading radiographic images.

For the first part of the challenge, one set of images was provided to the teams, along with known scores that had been visually generated. These were used to train the algorithms. Additional sets of images were then provided so the competitors could test and refine the tools they had developed. In the final round, a third set of images was given without scores, and competitors estimated the amount of joint space narrowing and erosions. Submissions were judged according to which most closely replicated the gold-standard visually generated scores. There were 26 teams that submitted algorithms and 16 final submissions. In total, competitors were given 674 sets of images from 562 different RA patients, all of whom had participated in prior National Institutes of Health-funded research studies led by Dr. Bridges. In the end, four teams were named top performers.

For the DREAM Challenge organizers, it was important that any scoring system developed through the project be freely available rather than proprietary, so that it could be used by investigators and clinicians at no cost. “Part of the appeal of this collaboration was that everything is in the public domain,” Dr. Bridges said.

Dr. Bridges explained that additional research and development of computational methods are needed before the tools can be broadly used, but the current research demonstrates that this type of approach is feasible. “We still need to refine the algorithms, but we’re much closer to our goal than we were before the Challenge,” he concluded.

HSS is also recognized as a leader in rheumatology, maintaining the No. 4 national ranking. It is the highest-ranked hospital in New York for rheumatology and has maintained a top 5 national ranking for the past 18 years.

This is the 30^th consecutive year that HSS has been among the nation’s top ranked hospitals.

Last month, the HSS Lerner Children’s Pavilion was named the best pediatric orthopedic hospital in the tri-state region, ranking among the nation’s finest in the 2021-2022 U.S. News & World Report’s “Best Children’s Hospitals” list.

“These recognitions reflect the commitment of every member of the HSS team to help each patient get back to what they need or love to do better than anyplace else in the world,” said Louis A. Shapiro, president and CEO at HSS. “We recognize our privilege and responsibility to advance 158 years of specialization each day, and innovate new ways to serve the millions of people whose lives and livelihoods are impacted by musculoskeletal conditions every year.”

In 2020, HSS transformed to support the community response to COVID-19, while continuing to provide both non-surgical and surgical care for nearly 125,000 pediatric and adult patients compromised by joint pain, trauma and sports injuries, osteoarthritis, rheumatoid arthritis, back pain, spinal disorders and conditions of the hand, upper extremities, foot and ankle.

“This recognition is a tribute to the excellence and dedication of the HSS staff, and the trust placed in us to meet even the most complex challenges,” said Bryan T. Kelly, MD, surgeon-in-chief and medical director of HSS. “Our sole focus on musculoskeletal health uniquely enables us to advance the field in patient care, research, innovation, and education.”

For the 2021-2022 rankings, U.S. News evaluated more than 4,500 medical centers nationwide in 26 specialties, 10 procedures and conditions. In the 16 specialty areas, 134 hospitals were ranked in at least one specialty. Further, HSS outperformed in all areas of measurement for orthopedics, including back surgery and spinal fusion, hip fracture, hip replacement and knee replacement. Notably, HSS was acknowledged for its leadership in non-surgical care and treatment as an alternative to back surgery.

“We are proud to be recognized for providing outstanding care for people with rheumatic and autoimmune diseases, which is critical to the integrative care approach at HSS,” said S. Louis Bridges, Jr., MD, PhD, physician-in-chief and chief of the Division of Rheumatology at HSS. “Our rheumatologists and researchers are leaders in the discovery of novel pathways and treatments to achieve the goal of improving patient lives everywhere.”

Additionally, HSS provides care to the highest-performing professional, collegiate and amateur athletes and organizations around the world, including USA Basketball, Fédération Internationale de Football Association (FIFA), UFC, the Brooklyn Nets, the New York Giants, the New York Knicks, the New York Mets and the New York Red Bulls, among others.

The research focuses on the diagnosis of renal disorders, the risk of venous thromboembolism after total knee replacement (TKR), and the care of pediatric and young adult patients with rheumatologic diseases. There are also studies related to the care of rheumatology patients during the COVID-19 pandemic.

“While there have been significant advances in science over the years, there are areas of unmet needs warranting continued investigation,” said S. Louis Bridges, Jr., MD, PhD, Physician-in-Chief, Chair of the Department of Medicine and Chief of the Division of Rheumatology at HSS. “HSS has a relentless focus on improving patient care through innovation and discovery. By spearheading multi-center studies, clinical trials, and laboratory-based research, we continue to improve the quality of life for patients affected by rheumatic and musculoskeletal conditions.”

What follows are some highlights from the meeting:

Geographical Variations in COVID-19 Perceptions and Patient Management: A National Survey of Rheumatologists

A study led by HSS rheumatologist Bella Mehta, MBBS, MS, looked at the perceptions and behaviors of rheumatologists in the United States regarding the risk of COVID-19 for patients with autoimmune disorders and how those patients were managed with immunosuppressive and anti-inflammatory medications. The 271 respondents were asked whether patients with rheumatic diseases were at higher risk of COVID-19 and whether the pandemic had led them to reduce the use, dosage, or frequency of biologics or steroids. Overall, the survey found geographical variations regarding perceptions of patients’ risk of COVID-19, with responses that were significantly different in the Northeast region of the United States compared with other regions.

Can a Clinical Disease Activity Index Based on Patient-Reported Joint Counts (PT-CDAI) Be Used to Inform Target-Based Care in Telemedicine? An Analysis of 2 Early RA Cohort Studies 

A team that included HSS rheumatologist Vivian P. Bykerk, BSc, MD, FRCPC, looked at data from two cohort studies on patients with early rheumatoid arthritis (RA) that compared patient and physician assessment of tender and swollen joints. This research is important because COVID-19 has forced rheumatologists to shift from in-person clinical visits to telemedicine, which limits their ability to carry out complete joint exams. The study found that patient and physician assessments had good agreement when it came to identifying active versus controlled disease activity. In addition, the researchers reported that predictors of higher discrepancies between patient and physician assessments may help identify patient subsets that could benefit the most from more physician-guided training at joint self-assessments as well as more probing questioning during telehealth visits to confirm active synovitis.

Characterization of Antiphospholipid Antibody-Associated Nephropathy: An International Survey of Renal Pathology Society Members

A survey led by HSS rheumatologist Medha Barbhaiya, MD, MPH, sought to determine whether pathologists worldwide use uniform criteria to distinguish antiphospholipid antibody-associated nephropathy (aPL-N) from other forms of thrombotic microangiopathy. The study was done in parallel with an international effort to develop new classification criteria for antiphospholipid syndrome. The web-based survey included 780 members of an international Renal Pathology Society; 111 renal pathologists responded, representing 33 countries. The participants were asked to determine whether two acute and eight chronic aPL-N features were consistent with acute or chronic aPL-N without and were not provided with serology information. Results from the survey indicated that more than 90% of pathologists worldwide agreed that the renal pathologic features most specific for aPL nephropathy are noninflammatory glomerular or small arterial microthrombi and organized microvascular thrombi with recanalization. In the absence of serologic data, more than 75% of pathologists indicated lack of specificity of chronic glomerular or small arterial changes. These findings indicate the importance of serologic test results in biopsy interpretation and suggest higher specificity for certain acute or chronic features.

The Risk of Venous Thromboembolism After Septic Total Knee Replacement (TKR) Revision Is Double the Risk After Aseptic TKR Revision: An Analysis of Administrative Discharge Data

A team led by HSS rheumatologist  Anne R. Bass, MD, assessed the 90-day risk of postoperative venous thromboembolism (VTE) in people who underwent revision TKR surgery. Although it was already known that infection can increase the risk of thrombosis by triggering coagulation pathways, the impact of infection in this context was not well understood. The study, which included 25,441 of these surgeries performed between 1998 and 2014, used data from the New York Statewide Planning and Research Cooperative System. Overall, 69% of these revisions were for mechanical causes (aseptic), 28% were for infection (septic), and 3% were related to a periprosthetic fracture. The researchers found that the risk of VTE after septic revision surgery was double the risk after aseptic revision surgery, and was 2.6-fold higher after revision surgeries for fracture. These findings point to the importance of taking infection and fracture status into account when planning VTE prophylaxis for patients having revision surgery.

Using a Patient-Engaged Approach to Identify Cross-Cutting Disease Factors Impacting Mental Health in Youth with Rheumatologic Disease

A team including HSS chief of pediatric rheumatology Karen Brandt Onel, MD, examined the mental health experiences of those with juvenile arthritis, juvenile dermatomyositis, or systemic lupus erythematous. It included patients aged 14 to 24 and parents of patients between the ages of 8 and 24. The primary outcome was the presence of any clinical or self-diagnosed mental health problem. The survey included information on cross-cutting disease factors such as disease duration, active disease status, current steroid medication, history of disease flare following remission, and appearance-altering comorbidities (such as psoriasis, stretch marks, alopecia, skin ulceration, and visible scarring). The researchers also examined results by mental health problem (depression, anxiety, and self-harm/suicidal ideation). Overall, they found that certain rheumatologic disease factors, including those that alter appearance, are predictive of mental health problems such as depression or anxiety. The findings will help identify targets for mental health screening in youth with rheumatologic diseases.

New Juvenile Idiopathic Arthritis Quality Measure Set for the Pediatric Rheumatology Care and Outcomes Improvement Network

A team that included HSS pediatric rheumatologist Nancy Pan, MD, reported highlights of new quality measures for the treatment of juvenile idiopathic arthritis. The study also provided information about the performance of these new measures, which were created by the Pediatric Rheumatology Care and Outcomes Improvement Network. The measures take into consideration clinical health importance, scientific validity, and feasibility, as well as best practices. They include both clinical evaluations based in part on the clinical Juvenile Arthritis Disease Activity Score and patient-reported outcomes such as pain, physical function, and overall well-being. An analysis of the new measures found that they are feasible for use on patients with juvenile idiopathic arthritis and can help to maximize quality improvement efforts and optimize the delivery of care.

“Dr. Bridges is a distinguished and well-respected physician-scientist whose work has led to great improvements in patient care,” said Bryan Kelly, MD, Surgeon-in-Chief and Medical Director at HSS. “His experience and expertise will only enhance our commitment to delivering high-quality and high-value healthcare.”

Dr. Bridges, a rheumatologist, is the director of the Division of Clinical Immunology and Rheumatology at the University of Alabama at Birmingham (UAB), where he serves as the Anna Lois Waters Endowed Chair of the Division of Clinical Immunology and Rheumatology. He is also the Director of UAB’s Comprehensive Arthritis, Musculoskeletal, Bone, and Autoimmunity Center.

He earned his bachelor’s degree from the University of Notre Dame, his medical degree from Louisiana State University School of Medicine and his PhD degree in microbiology from UAB. He completed his residency and fellowship at the University of Texas Medical Branch in internal medicine, where he also served as Chief Medical Resident. He has been continuously funded by National Institutes of Health grants and is focused largely on rheumatoid arthritis susceptibility and treatment response. Dr. Bridges has authored more than 140 manuscripts and 20 book chapters and has served as editor of three editions of the text Vasculitis, published by Oxford University Press. In January 2020, Dr. Bridges was appointed president of the Rheumatology Research Foundation and member of the Executive Committee of the American College of Rheumatology.

Additionally, he is a former co-editor of Arthritis & Rheumatology and former chair of the NIH Arthritis, Musculoskeletal, and Skin Study Section. In addition to membership on several American College of Rheumatology committees, he previously served as chair of the ACR Committee on Research and as a member of the Rheumatology Research Foundation’s Scientific Advisory Council.

“I am excited and humbled by the privilege of leading the renowned HSS Department of Medicine to further advance the science and practice of Rheumatology and related specialties,” said Dr. Bridges. “Together with esteemed colleagues in Orthopedics, there is no greater opportunity to impact musculoskeletal health worldwide.”

Dr. Crow will remain at HSS continuing her work as the Benjamin M. Rosen Chair in Immunology and Inflammation Research and the Joseph P. Routh Professor of Rheumatic Diseases Medicine.

“Dr. Crow is an exceptional international leader, and her dedication to improving the lives of patients with autoimmune conditions has led to incredible scientific breakthroughs,” said Dr. Kelly. “We’re looking forward to her continued success at HSS.”

“The advancement of patient care practices at HSS is demonstrated through our commitment to recruiting outstanding physician leaders in our clinical specialties, such as Dr. Bridges,” said Louis A. Shapiro, president and CEO at HSS. “Dr. Bridges has made significant contributions to the field of rheumatology. He approaches complex cases with dedication and compassion, and is an advocate for populations disproportionately affected by rheumatic diseases. We are proud to welcome him to HSS.”