As one of the five Arthritis Foundation Rheumatology Research Fellowship grant awardees for 2020, I have been fortunate to have had many opportunities to participate in research. I was excited not only to attend the American College of Rheumatology (ACR) virtual conference in November but honored to present some of the research I have been working on during my fellowship at Duke University.
Despite the pandemic, there have been many exciting advances in pediatric rheumatology research this year that were presented at ACR. The amount that we have learned about COVID-19 and the work the pediatric rheumatology community has done to understand the multisystem inflammatory syndrome in children (MIS-C) that can result from COVID infection is truly impressive. The work in this area highlighted the importance of collaboration in the community to advance evaluation and treatment, and we have learned much since last March. The dedication to move the work forward in these unprecedented circumstances has been both inspiring and energizing.
I was excited to be able to present some of the projects I have been working on during my fellowship. I have had the opportunity to work with wonderful mentors during my fellowship at Duke who have helped me with my research projects.
One of the projects I presented focused on the treatment of autoimmune brain disease and outcomes of patients treated with particular therapies (rituximab and intravenous immunoglobulin, or IVIG). We looked at how they responded to the therapies as well as at the rates of serious infection with these therapies. We found that overall, these patients responded well to rituximab and IVIG and did not need to escalate to other therapies; using IVIG with rituximab did not seem to impact its efficacy. The rate of serious infections was low.
Another project I shared is a study to determine the highest research priorities in childhood lupus. We conducted interviews with lupus experts all over the world to ask about the highest priorities right now for pediatric lupus research. Many experts saw the need for determining biomarkers as a very important priority. There was also discussion about how to best conduct longitudinal studies to follow patients from their diagnosis into adulthood in order to better understand the disease.
The final project was a combined quality improvement effort by both the adult and pediatric rheumatology divisions focused on monitoring the bone health of patients who are treated with corticosteroids. Our group tried to improve vitamin D supplementation among patients taking chronic corticosteroids in order to optimize the patients’ bone health. Through educational conferences with faculty and fellows, we were able to improve the percentage of our pediatric patients on corticosteroids who were prescribed vitamin D.
Thank you to the Arthritis Foundation for its continued support of my fellowship and learning. I am looking forward to applying the knowledge from my fellowship to my practice in pediatric rheumatology and help to advance treatments and care for young people living with rheumatic diseases. —Laura Cannon, MD, Duke University Children’s Hospital