What does the gut have to do with the heart in scleroderma? Quite a lot, as it turns out. In this episode, we talk with Dr. Zsuzsanna McMahan about new findings from the GENISOS cohort exploring the relationship between gastrointestinal and cardiac manifestations in systemic sclerosis, including the striking timing and strength of these associations and what they might reveal about shared disease mechanisms. Then we shift gears to the realities of academic medicine: Dr. McMahan shares lessons from moving from Johns Hopkins back to UT Houston, rebuilding clinical and research programs, forging new collaborations, and, perhaps most importantly, deciding what to say yes to and what to leave on the table

The Gut–Heart Axis in Systemic Sclerosis: Evidence From a Large Prospective Early Disease Cohort

In this episode, we speak with Dr. Pamela Weiss, pediatric rheumatologist, epidemiologist, and physician-scientist at Children's Hospital of Philadelphia, about axial juvenile spondyloarthritis (axJSpA). Dr. Weiss discusses her study examining MRI findings in children and young adults receiving TNF inhibitors, including changes in sacroiliac joint inflammation, the relationship between imaging and patient-reported outcomes, and implications for clinical care and future research. She also shares her career journey, the mentors who shaped her path, and advice for the next generation of pediatric physician-scientists.

Measuring the Impact: Magnetic Resonance Imaging Response of Sacroiliac Joints to Tumor Necrosis Factor Inhibitors in Youth With Axial Disease

In this episode, we speak with Dr. Ellen Romich about her post hoc analysis of the RITAZAREM trial, exploring factors associated with relapse in ANCA-associated vasculitis. She discusses the study design, key findings—including the roles of rituximab, azathioprine, CD19 positivity, ANCA status, and immune reconstitution—and the clinical implications and limitations of the work. Dr. Romich also shares her path into rheumatology, how she became involved in the analysis, and what questions she hopes to tackle next.

Risk Factors for Relapse in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis Among Patients With Relapse After Induction of Remission With Rituximab

Dr. Vivian Kawai and Matthew Chung discuss their research on the clinical significance of high-titer antinuclear antibodies (ANA) using electronic medical record data and PheWAS analysis. They explore the study's design, key findings, clinical implications, and limitations, while also discussing how an undergraduate research experience evolved into a successful mentorship and publication.

Clinical Conditions Associated With a High Antinuclear Antibody Titer in Individuals Without Autoimmune Disease

In this episode, we explore how artificial intelligence and machine learning are advancing the use of electronic health record data in rheumatology. Dr. Kat discusses the development and validation of a natural language processing–based model to infer rheumatoid arthritis disease activity from structured and unstructured clinical data, its application in studying cardiovascular outcomes, and the challenges of deploying predictive models across different health systems. The conversation also examines the future of real-world evidence generation, the practical limitations of AI in clinical research, and Dr. Kat's career journey, offering insights and advice for the next generation of physician-scientists.

In this episode, Michael J. Ombrello, MD, explores how our understanding of Still's disease has evolved, from recognizing interstitial lung disease as a key manifestation to uncovering the immunologic and genetic factors that may shape disease severity. He discusses insights from a National Institutes of Health natural history study, including interferon signatures, HLA associations, drug-associated immunologic reactions, and exome sequencing, and explains what these findings could mean for future diagnosis, risk stratification, and treatment. The conversation also turns to Dr. Ombrello's own career path, the personal experiences that inspire his research, and the mentors who helped shape his journey as a physician-scientist.

Type I Interferon Signature is Associated With Lung Disease, Drug-Associated Immune Reactions, and Genetic Variation in Interferon-Linked Pathways in Still Disease

In this episode, Nicholas P. McCormic discusses new real-world research from the RISE registry examining the use of GLP-1 receptor agonists in patients with rheumatic and musculoskeletal diseases. He explains the motivation behind the study, its design, and key findings on medication use, weight loss, and differences between semaglutide and tirzepatide, while highlighting important considerations for clinicians and patients. Nick also shares insights into the strengths and limitations of using registry data before reflecting on his journey from psychology and sociology to earning a Ph.D. focused on chronic disease management and rheumatology, offering advice for aspiring researchers and a look at his future work.

In this episode, we talk with Dr. Ji Soo Kim about a new tool designed to help people with scleroderma better understand and manage their disease. Using information collected over many years from patients receiving routine care, Dr. Kim developed an interactive platform that turns complex medical data into easy-to-understand charts and predictions. We discuss how the tool can help patients and doctors track disease progression, compare experiences with similar patients, and make more informed treatment decisions together. Dr. Kim also shares insights into the challenges of working with real-world health data, the future of personalized medicine in rheumatology, and the career path that led to this innovative work.

Development of a Personalized Visualization and Analysis Tool to Improve Clinical Care in Complex Multisystem Diseases With Application to Scleroderma