In an interview with DocWire News, Mithu Maheswaranathan, MD, a rheumatologist at Duke University Health, reflected on rheumatology developments in 2023 and looked ahead to the developments and challenges the field may face in 2024. Dr. Maheswaranathan explained that 2023 saw the exploration of steroid-sparing therapies for rheumatic diseases, the U.S. Food and Drug Administration’s approval of sarilumab for patients with refractory polymyalgia rheumatica, and the expansion of digital medical education. Dr. Maheswaranathan noted that patients with lupus currently have limited therapeutic options, and social determinants of health—such as socioeconomic inequities, low access to care, medication nonadherence, and health illiteracy—can negatively impact disease activity, treatment effectiveness, and health outcomes. He stressed that rheumatologists need to become more aware of the causes and consequences of racial disparities in health care.
However, Dr. Maheswaranathan predicted positive changes for the field of rheumatology in 2024. Ongoing clinical trials examining novel therapies for lupus and lupus nephritis—including belimumab, anifrolumab, and obinutuzumab—may help target different immune system pathways to improve treatment options in this patient population. The continued advancement and utilization of telemedicine and artificial intelligence (AI) may also allow for increased access to rheumatology care for underserved communities. He predicted that AI may help resolve diagnostic dilemmas, create initial drafts of materials, and automate burdensome daily tasks. Further, he highlighted that targeted therapies, such a chimeric antigen receptor T-cell therapy, will be better analyzed in patients with rheumatic diseases in upcoming clinical trials. Dr. Maheswaranathan concluded that although there are still gaps in what rheumatologists know about targeted therapies, the field may see new explorations and discoveries in 2024 that challenge the current understanding of rheumatic disease treatment.