You may notice a theme to this issue of LEAP: change. Our cover story features research in Sjögren’s that has the potential to transform the way drugs are tested in clinical trials, to eliminate some of the time-consuming, trial-and-error process that is so familiar to patients and doctors alike, and even to lead to the development of new drugs that target the molecular mechanisms of disease. Like the Rubik’s cube on the cover, Sjögren’s – like many rheumatic diseases – is a complex puzzle with multiple immune pathways; in turn, each patient’s disease is an individual piece of that puzzle. This research, led by Livia Casciola-Rosen and Alan Baer, is precision medicine on the molecular level. It is exciting, it is revolutionary, and it is definitely a change for the better.
New discoveries by Zsuzsanna McMahan and colleagues may help limit the damage from severe Raynaud’s phenomenon in scleroderma. This work has the potential to help prevent the devastating loss of function from digital gangrene. As part of our ongoing commitment to tell the stories of people – those who work here and the patients we care for, and think about, and are committed to helping – we are sharing the stories of two of our patients who are coping with serious autoimmune disease. They are inspiring to us, and we hope they will be to you, as well.
Also changing: the way you see the doctor. Precision is not limited to molecular pathways. Patients have enormous experience of their disease and lives, and medicine does not adequately access this unique perspective. Clifton Bingham is leading a new program in rheumatoid arthritis, creating and applying new tools to help patients quantify and communicate what’s really happening in their lives – what they’re not doing because of fatigue, for example – and helping physicians to ask questions about things that otherwise might not be addressed during the visit. Thomas Grader-Beck is spearheading a pilot program to help physicians be more responsive to their patients, and to allow patients to keep their physician updated on how they’re doing, in a highly nuanced way.
And finally, there’s the story of how our clinic has been beautifully updated and, in fact, transformed. Those of you who remember how it used to be may have done a doubletake the first time you saw it after the makeover. We know that we are providing the same great care, but it is nice to do it in a setting worthy of our patients, our partners in discovery and care. I came across a LEAP-related quote by Harvey Mackay that seems to capture how we feel here: “A great accomplishment shouldn’t be the end of the road, just the starting point for the next leap forward.”
Looking forward to new roads of discovery and more good changes,
Antony Rosen, M.D.
Director, Division of Rheumatology
Vice Dean for Research