As a disease, lupus can be menacing, even treacherous. The analogy with a wolf is apt since, at its worst, lupus can be a predator that snatches away young people. Not surprisingly, clinicians who specialize in this condition have dispositions that may differ from that of the average rheumatologist who handles more chronic and indolent diseases. Lupus investigators are a passionate and often strong-willed lot. Meetings on lupus can be intense occasions, filled with opinion, argument, and contention. They are definitely more exhausting than meetings on other diseases.
Research on lupus is full of controversy. What is the right way to treat nephritis? Is anti-DNA a reliable biomarker? Is estrogen replacement safe? Acronyms for disease activity proliferate, and people fight over the nuances in counting disease manifestations and the validity of including serology or patient reports in generating a score for current activity. Is the SLEDAI better than ECLAM or RIFLE? And when one of these indices is named SLAM, you know that these people are tough and mean business.
“Rheuminations” Answer
In addition to belimumab, the other FDA-approved drugs for lupus are:
- Aspirin
- Hydroxychloroquine sulfate
- Prednisolone
- Triamcinolone hexacetonide (discoid lupus)
Sharing Secrets
On the way to the airport in our shiny boat of a conveyance, we drove along a wide suburban highway surrounded by big box stores and every fast-food restaurant in the world—McDonald’s, Jack in the Box, Taco Bell, and more. A panorama of logos enticed us to exit the thoroughfare and dine on meals that, in a single sitting, would provide enough salt to fill the extracellular space of the average person with sodium for a week or two. No such indulgence for us. The meeting organizers had thoughtfully provided us with healthy box lunches that even contained an apple each.
Traffic slowed and snarled, as is inevitable in that area of the world. With the Scylla and Charybdis of lupus trial design behind us, we exchanged the usual gossip about the comings and goings in academia. We then moved onto personal subjects, including the lifestyles of today’s academicians and the struggle to balance the demands of work and family. In that vein, Dr. D. described a retreat that he had had with his division’s faculty. At this retreat, each faculty member was asked to tell the group something about himself or herself about which the others were likely unaware. Dr. D. relayed how interesting this activity was as the group heard about the “secret” lives of their colleagues, including hobbies, avocations, and travels. At the top of the list were remnants of past history that simply do not come up in conversation.
