“It answers the question whether or not we can implement a diet and exercise intervention into the community setting rather than in a research laboratory,” he said.
Researchers saw a significant decline in pain, to a clinically significant degree, in the diet and exercise group, Dr. White said.
“It’s really exciting stuff from our perspective,” he said. “Only a third of physicians recommend exercise to their patients, and this study supports the need for this to change.”
Urinary Biomarkers for LN
Dr. Kim discussed a study out of Johns Hopkins through the Accelerating Medicines Partnership that found that urinary interleukin (IL) 16 is associated with the proliferative form of lupus nephritis (LN).5 He said this makes sense because immune cells that make IL-16 are localized in the most vulnerable part of the kidney in patients with LN, the glomerulus and interstitium.
“I think this is really an important observation; it also allows us to find those people with proliferative lesions more easily,” he said.
He said IL-16 has been validated in other studies, making it a lead biomarker for LN. Nevertheless, he said, the findings need validation and there would likely be “more power” in the diagnostic powers of biomarkers when taken together.
“I think it’s naive to think that one biomarker is going to fix everything,” Dr. Kim said.
Balance of Daily Activities & RA
Dr. White said he was struck by an ACR session on finding the right balance in daily life for people with RA.
Experts at the University of British Columbia, Vancouver, who have studied the totality of daily activities—sitting, sleeping, exercise and other activity over an entire 24 hours—said the idea is to be mindful of “not only how much physical activity you should do, but also how much rest you should have and how much down time you should have,” Dr. White said. The discussion stemmed from studies analyzing the activity and sleep patterns of people with rheumatic diseases.6
Dr. Kuhn said assessing functional outcomes using an approach like this will be important as clinicians turn to treat-to-target strategies.
“Are we really hitting a target if our patient doesn’t feel better?” she said.
CAR T Cell Therapy in SLE
Dr. Kim discussed the excitement surrounding findings of efficacy for chimeric antigen receptor (CAR) T cell therapy in five patients with refractory systemic lupus erythematosus (SLE), all of whom achieved remission.7
