ACR CONVERGENCE 2021—The Plenary Sessions highlighted select abstracts of interest to the general ACR audience. This year at Plenary Session 2, six researchers shared highlights from their work.
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Racial Disparities in Renal Outcomes in Children with SLE
Joyce Chang, MD, MSCE, assistant professor of pediatrics, Harvard Medical School, Boston, kicked off the session talking about a study characterizing trends in renal outcomes over time among hospitalized children with systemic lupus erythematosus (SLE). The researchers tested whether racial disparities in renal outcomes have changed over time.1
“New advances in therapeutics and care quality guidelines could narrow disparities by reducing variation or widen them if advances do not reach groups equally,” she said.
In the study, researchers found a statistically significant decrease in SLE hospitalizations associated with adverse renal outcomes overall, reflecting progress in pediatric lupus care. On average, improvements were similar in each racial/ethnic group. However, relative Black-white disparity persists, and the magnitude of disparities may vary by hospital catchment area.
So where do we go from here? Dr. Chang noted that a “focus on improving care quality alone won’t be sufficient to close the gap in racial disparities, and we need to know root causes in order to identify processes that preferentially improve outcomes among highest risk groups.”
For next steps, she recommended “systematic collection of local data on individual and area-level social determinants of health to understand why differential risks occur.”
Effects of Vitamin D & Fish Oil
Karen H. Costenbader, MD, MPH, professor of medicine, Harvard Medical School, and director of the Lupus Program, Brigham and Women’s Hospital, Boston, presented results from the Vitamin D and Omega-3 trial (VITAL), which studied the use of vitamin D and fish oil for the prevention of autoimmune diseases.2
Despite the significant burden of illness of autoimmune diseases, no current preventive measures are at the rheumatologist’s disposal.
Vitamin D and omega-3 fatty acids, commonly known as fish oils due to their abundance in fish, have long been of interest to the scientific community. However, no prospective randomized trials have tested the effects of vitamin D or fish oil supplementation on the incidence of autoimmune disease over time.
VITAL was a randomized controlled trial of more than 25,000 patients who received 2,000 international units of vitamin D daily and 1 g of fish oil daily vs. placebo for the prevention of autoimmune disease in adults. The primary outcome was all incident autoimmune diseases determined via participant self-reporting and extensive medical record review for diagnoses and criteria.