Care & Clinical Trials
Cynthia Aranow, MD, has treated hundreds of patients with systemic lupus erythematosus (SLE) in the last two decades. Given the countless visits and contacts she’s had with SLE patients, she doesn’t specifically remember calling her patient Ramona* at home.
But Ramona remembers.
“There were times when I didn’t go the doctor,” she says. “And she would call me and be like, ‘You’re not coming in. You have to come in if you want me to help you and work with you.’ ”
The relationship that develops between doctor and patient can produce side effects that never get noted in a case report or published in a paper—even if the relationship has the context of a clinical trial. This is the story of one of those side effects.
Trust Built on Making Sure
Dr. Aranow is assistant professor of rheumatology at the Columbia University Medical Center in New York City—one of only nine National Institutes of Health (NIH) Autoimmune Centers of Excellence. (See “A Range of Research,” at right, for more on Dr. Aranow’s work.)
Columbia’s lupus clinic is where Ramona receives treatment. Now in her early 30s, Ramona was diagnosed with SLE when she was 14. Her disease was very active in the early years, and while aggressive treatment has made it more controllable, inflammation damaged her kidneys and she needs ongoing therapy.
A Range of Research
Dr. Aranow’s interest in basic SLE research is intensified through her clinical research and her interactions with patients like Ramona. She was lured to the research team of Betty Diamond, MD, chief of Columbia’s rheumatology division, four years ago when Dr. Diamond offered her the opportunity to add translational research to her mix of responsibilities.
Dr. Aranow’s research foci include studying the fundamental mechanisms underlying the pathogenesis of SLE, investigating why patients with SLE sometimes develop neuropsychiatric problems, and looking for new therapies for lupus.
She is currently involved in several clinical trials sponsored by both industry and the NIH, targeting diseases such as lupus, scleroderma, and rheumatoid arthritis with approaches ranging from biologics to autologous stem cell transfer.
Dr. Aranow’s other SLE research activities include:
- Lupus Clinical Trials Consortium, a network of 23 medical centers that facilitates clinical trials.
- Immune Tolerance Network, a collaborative that is developing therapies for immune-mediated diseases based on the induction of tolerance.
- Systemic Lupus Erythematosus International Collaborating Clinics, an international group of researchers developing valid outcome measures for lupus.
- Medical advisor to two chapters of the Lupus Foundation of America.—LB
The deaths of two young friends with lupus encouraged Ramona to take control of her own health, yet she did not always comply with her treatment plan. “Every time I had a different doctor,” she says. “At times, I wasn’t taking my medicine because I didn’t feel like the doctors were caring and worrying about what I was doing.”