HCPLive Podcasts

At HCPLive, we’ve had the incredible privilege of speaking with doctors from a variety of different clinical fields as well as different cultural, racial, and ethnic backgrounds. Without their dedication, insights, and generosity, the health care system and the world at large would be at a loss. Even publications such as our own benefit from their work in a myriad of ways. In this episode of DocTalk, we offer listeners a glimpse of some of the most memorable and insightful interviews regarding skin of color, health inequities, and how clinical fields such as dermatology and rheumatology can improve care for Black and Brown patients and physicians alike. This episode’s featured segments include: Raj Chovatiya, MD, PhD, on diversifying clinical trials and other studies Karan Lal, DO, MS, FAAD, on scientific literature dedicated to skin of color Megha Shankar, MD, on avoiding labeling certain skin types as normal/abnormal Ehizogie Edigin, MD, on the prevalence of systemic lupus erythematosus flares in African Americans Titilope Fasipe, MD, PhD, on acknowledging deficiencies in sickle-cell care in Black patients

Rheumatology Network interviewed Terence Rooney, MD, to discuss the findings of a Network Meta-Analysis that examined the efficacy of guselkumab (TREMFYA) for skin clearance and joint improvements in patients with psoriatic arthritis.

Across all areas of study in health care and especially in recent years, African American patients and physicians have experienced racial inequity regarding telemedicine practices across the US. However, a new pilot trial from the Perelman School of Medicine at the University of Pennsylvania suggested subtle modifications in the methods of virtually engaging with Black patients that could be used to better communicate with populations affected by these inequities.Data from the trial showed that Black patients with cardiovascular disease covered under Medicaid and Medicare insurance are significantly more likely to share blood pressure measures with a clinician through text messages as opposed to a healthcare system online portal.Jennifer Lewy, MD, MPH, Director of the Penn Women’s Cardiovascular Center, spoke of the motives behind this trial as well as the uptake and acceptability of a text-based model for at-home blood pressure monitoring when compared to online virtual patient portals among Black patients with Medicaid or Medicare.

In early February, the American College of Rheumatology (ACR) announced an updated version of its COVID-19 Vaccine Clinical Guidance for Patients with Rheumatic and Musculoskeletal Diseases. This update - the fifth of its kind- featured support for booster and supplemental doses in addition to recommendations regarding the timing of the injection as well as immunomodulatory medication use. Revisions were also made regarding pre- and post-exposure prophylaxis with monoclonal antibody treatment, which are still supported by the guidance despite some limitations being issued by the US Food and Drug Administration. In a statement made on the day of the announcement, Jeffrey Curtis, MD, MS, MPH, Chair of the ACR COVID-19 Vaccine Guidance Task Force, said that “There is now more nuance with supplemental and booster dose recommendations that should prompt us to ask patients not only whether they have been vaccinated, but with what, how many times, and how recently.” Curtis recently sat down with HCPLive to speak of the main updates included in the newest version of the guidance and the implications of these changes for patients with rheumatic disease.

In this episode of DocTalk, we interview Janae Sharp, founder of the Sharp index, on some of these larger, slightly philosophical questions surrounding physician burnout, including how to measure and define success, as well as the deeper layers of stigma that must be addressed as part of the process.

Though sickle cell disease had been present in Africa for over 5000 years, it was first “discovered” in 1910 when a dental student named Walter Clement Noel became the first patient to be formally diagnosed. From there, more would be uncovered about the disease in the decades following his diagnosis, such as how it disproportionately affects patients of African descent.According to the Centers for Disease Control and Prevention, about 1 in every 13 Black infants in the US are born with the trait for sickle cell disease. Additionally, diagnosis and screening for sickle cell are still lacking in lesser-resourced regions of Africa and the US alike.Ifeyinwa “Ify” Osunkwo, MD, director of Sickle Cell Disease Enterprise at the Levine Cancer Institute and Professor of Medicine and Pediatrics at Atrium Health, spoke of advancements in the field of sickle cell disease including chronic disease-managing therapies, and how physicians unfamiliar with the disease could collaborate with hematologists to provide the best care for those affected by sickle cell.

In late January, a team of investigators from the Centers for Disease Control and Prevention (CDC) reported findings from the Vaccine Adverse Event Reporting System (VAERS) indicating a significantly low risk of myocarditis following vaccination with either available messenger RNA (mRNA) vaccine for COVID-19 in persons aged 24 years and younger.Cases of the inflammatory heart event occurred 1626 times after an mRNA vaccine dose in US patients from December 2020 to August 2021.Though the prevalence of myocarditis was deemed significantly low (.0000046%), it is something that Dr. Matthew E. Oster,MD, MPH, of the CDC and the Emory University School of Medicine says is worth taking note of. Dr. Oster spoke of how the CDC is monitoring these events, as well as the risks to cardiac health that patients who aren’t vaccinated against COVID-19 face.

Today marks the fourth-ever National Women Physicians Day, an event that that is intended to pay respect to women physicians across the country. It’s held each year on Elizabeth Blackwell's birthday, who was the first female medical doctor in the United States. Though much has changed since then, there are still fewer female doctors nationally than male doctors, an issue often caused by gender inequalities.Dr. Marcia Klein-Patel, Chair of the Alleghany Health Network’s Women’s Institute, spoke of gender biases in the medical field, representation issues for women and minority groups in both professional and clinical areas, and what could be done to raise awareness and create a more inclusive and fair medical community.

Last week, Janssen announced results from a network meta-analysis (NMA) that showed that the biologic therapy guselkumab ranked highest for overall level of skin clearance. The NMA involved 33 phase 3 randomized clinical trials and 15 different targeted therapies including risakinumab and more.Philip J. Mease, MD, director of rheumatology research at the Swedish Rheumatology Research Group, spoke of how the biologic distinguished itself from other targeted therapies in the network meta-analyses, and how these kinds of analyses could aid physicians in treating patients affected by psoriasis.

Prior to the COVID-19 pandemic, the subject of physician burnout was likely not considered or completely understood by large swaths of the American public. Despite this, burnout has been an issue that has plagued physicians for decades prior to the pandemic, and the consequences of it are far-reaching.In an interview for the latest installment of Crisis Point with Connor Iapoce, Dr. Lakshmana Swamy detailed the history and complications of burnout and how the mental, physical, and emotional complications associated with it worsened with the COVID-19 pandemic.Dr. Swamy described burnout as chronic work-related stress brought on by 3 key dimensions including emotional exhaustion, a lack of personal accomplishment, and depersonalization.He spoke on how these dimensions were affected by the ongoing pandemic, and how physicians are coping with the onslaught on misinformation, distrust, and complications with the healthcare system.

In mid-January, Mount Sinai Health System and Icahn School of Medicine announced the launch of the Institute for Airway Sciences (IAS), a multidisciplinary institute intended to establish new therapies for patients with sinus, laryngotracheal airway, and lung diseases.The institute will be opened under the guidance of Eric Genden, MD, MBA, Professor and System Chair of Otalaryngology, who spoke on how the institute will encourage new ways of approaching airway diseases through collaboration, grants and scholarship opportunities. “The underlying goal (and) that the way that we do this is that instead of having a research institute in one silo, the clinical institute in another and then clinical trialists who are taking the signs and kind of trying and creating these trials, we're bringing them all together so that the scientists understand what are the problems that we're facing and they can get to work working with us on real pragmatic solutions,” Genden said.

In January, The American Red Cross reported that it was facing “its worst blood shortage in over a decade” amid surging cases of the Omicron variant of the COVID-19 virus. For the first time since its inception, the Red Cross declared a “Blood Crisis”, with blood and platelet donations reaching critically low levels.Among those affected are patients with sickle cell disease.Edward Ivy, MD, MPH, Vice Chief Medical Officer of the Sickle Cell Association of America (SCDAA), spoke of the implications of the blood shortage for patients with sickle cell disease, as well as promising new treatments that could be emerging in the coming years.

With Chronic Obstructive Pulmonary Disease (COPD) being cited as the third leading cause of mortality globally, the data surrounding the condition has naturally continued to broaden.In high-income countries, COPD is predominantly typically linked to cigarette exposure, tobacco smoke and poor sleep habits. However, people in low- and middle-income countries are often predisposed to a multitude of environmental factors that are not often considered outside of high-income settings. Trishul Siddharthan, MD, Division of Pulmonary and Critical Care at the Miller School of Medicine, University of Miami, speaks of environmental exposures associated with low- and middle-income countries as well as the lack of diagnostic resources for COPD in these settings.

With the Centers for Disease Control and Prevention observing a steady increase in influenza cases early in the year, the subject of influenza vaccination has become increasingly prevalent. Keipp Talbot, MD, MPH, Associate Professor of Medicine in the Division of Infectious Diseases at Vanderbilt University, sat down with HCPLive managing editor Kevin Kunzmann to discuss the most recent vaccine innovations that could come to influenza products.

DocTalk returns in 2022 with a discussion of the recent Food and Drug Administration (FDA) approval of tralokinumab for the treatment of moderate-to-severe atopic dermatitis in adult patients. For this episode, Jonathan Silverberg, MD, PhD, MPH, discusses the ECZTRA trials, 3 phase 3 trials that evaluated the efficacy of the biologic as a monotherapy as well as a combination therapy with topical corticosteroids.Tralokinumab is the first and only biologic approved by the FDA that binds to and inhibits the interleukin (IL)-13 cytokine, noted as a key driver of signs and symptoms of atopic dermatitis. Dr. Silverberg speaks on what this new treatment means for the future of atopic dermatitis management.

In this Derm Discussions, Moody speaks to how the coding changes can aid in streamlining billing documentation for dermatologists.

Dr. Jellinger joins the podcast to discuss the lipid section of the DCRM Multispecialty Practice Recommendations, as well the role of combination therapies and other concepts to lower LDL and what is coming next for the field of diabetes in 2022.

Donald Alcendor, PhD, joins to review currently available data surrounding the newest COVID-19 variant of concern, and shares guidance for concerned clinicians and the general public.

On this month's episode, we interviewed Courtney Wells, PhD, MPH, MSW, to discuss the impact of COVID-19 on the quality of life of patients with rheumatic conditions, focusing on perceived risk and decision making.

Soumya Chakravarty, MD, PhD, discusses the unmet patient needs in immune-mediated diseases as well as Janssen’s work in scientific innovation that allows patients to live their lives more unburdened by their disease. Chakravarty is the Sr Director and Strategic Lead in the Rheumatology Therapeutics area at Janssen.

The Director of Retina Services at Wills Eye Hospital joins to discuss the historic FDA approval granted for a novel method of ophthalmic care: a permanent implant that allows for vision-saving formula therapy to treat the eye continually.Read more about the PDS approval here.Episode notes:0:12 Intro 1:07 What is the Port Delivery System? 2:39 The history of developing the PDS 17:00 Is PDS exclusive to anti-VEGF? 19:52 Thoughts on the ranbizumab PDS approval 23:10 How will guidelines change? 24:15 Tips for best PDS use 26:30 Closing thoughts 29:40 Outro

Dr. Arianna Yanes provides insights into 7 new handouts developed by the Society for Pediatric Dermatology and how they aid nurses and teachers in creating a more inclusive setting for children with skin conditions.

E. Michael Lewiecki, MD, discusses “Controversies in Osteoporosis” and “What's New in Osteoporosis for 2021?” We deep dive into recent controversies and trends in osteoporosis management, predictions for 2022, and how COVID-19 had impacted the treatment landscape for rheumatologists.

Josh Mali, MD, of The Eyes Associates, joins HCPLive to review the key news and developments coming out of the American Society of Retina Specialists 2021 Scientific Meeting.

In this Derm Discussions, experts review the state of clinical innovation driving new opportunities in chronic skin disease care.

Sharon Hrynkow, PhD, joins the Rare Disease Report to discuss the ultra rare and heterogenous lysosomal storage disorder.

Roy Fleischmann, MD, discusses the recent Pfizer press release touching upon the safety of JAK inhibitors. He explains the recent scrutiny of JAKs, the concerns some rheumatologists have in regard to JAK inhibitors, and his personal opinions on prescribing JAK inhibiting drugs to his patients.

In this Derm Discussions, Brett King, MD, PhD, joins Brad Glick, DO, to discuss the potential of the JAK inhibitor class for dermatology.

Rheumatology Network sat down with Andrew L Concoff MD, FACR, CAQSM, to discuss value-based care, including the benefits, collaborate approach to working with payers, the revenue and cost savings, and how value-based care can support routine and consistent health visits.

Florian Thomas, MD, and Adrian Hepner, MD, cover the basics of the degenerative nerve disorder.

Stephen Russell, MD, talks about promising new data that has the potential to provide a breakthrough for treating the most common mutation of the rare genetic eye disease.

Dr. Childress said COVID-19 was difficult for many pediatric patients with ADHD

This week, we sat down with Daniel Hernandez, MD, and Shilpa Venkatachalam, PhD, MPH, of CreakyJoints, to highlight health disparities in marginalized communities and introduce their exciting new venture, CreakyJoints Espanol.

In this Derm Discussions, Misha Rosenbach, MD, discusses how rising temperatures and climate change, issues of public health concern, are relevant to the field of dermatology.

Jordana Hoppe, MD, discusses the burden of cystic fibrosis on infants and children.

We sat down with Philip J. Mease, MD, to discuss his study, “Comparative effectiveness of guselkumab in psoriatic arthritis: results from systematic literature review and network meta-analysis.”Time stamps: 0:35: Can you begin by giving me a general overview of the current treatment landscape for psoriatic arthritis? 2:12: Have you noticed any trends in treating psoriatic arthritis? 3:00: What are some of the challenges that rheumatologists face when trying to identify the most appropriate treatment option for their patients? 3:36: Why is discovering that guselkumab demonstrated efficacy that was comparable to other treatment options, such as subcutaneous TNF inhibitors so important? 5:17: Were there any limitations or strengths of the study that you would like to elaborate on? 8:21: Does your team plan on doing any further research on guselkumab for psoriatic arthritis? 9:29: Is there anything else that you'd like our audience to know about your research or psoriatic arthritis?

Dr. Paul Yang, of Casey Eye Institute, joins to discuss new ARVO 2021 data supporting the gene therapy for X-linked retinitis pigmentosa.

Ennis James, MD, discusses the challenges and lingering questions associated with the treatment of sarcoidosis.

Eric Wallace, MD, discusses Anderson-Fabry disease and the difficulties associated with screening, testing, and treatment.

In this Derm Discussions, Valerie Callender, MD, draws on her experiences in clinical practice to discuss cosmetic dermatology care practices and the challenges of this past year.

Kim Smith-Whitley, MD, discusses the history, presentations, and research status of sickle cell disease.

In a joint interview, 2 pediatric cardiologists discuss topics related to remote technologies and cardiological monitoring among pediatric populations.

In this Derm Discussions, Todd Schlesinger, MD, talks new therapies on the horizon and those that have already proven efficacious.

The University of Chicago hypertension expert discusses new ADA recommendations for cardiovascular risk management.