The Lancet Rheumatology in conversation with

In August’s episode, Dr Mrinalini Dey from the Centre for Rheumatic Diseases at King’s College London discusses her recent publication on the association between health literacy and outcomes in people with inflammatory arthritis in England. Health literacy—the ability to access, understand, evaluate, and use health information and services in ways that promote and maintain good health and wellbeing—is increasingly recognised as a key factor in promoting health and managing chronic diseases.
The World Health Organization has identified health literacy as central to the prevention and control of non-communicable diseases, such as rheumatic and musculoskeletal conditions. As a potentially modifiable social determinant of health, health literacy can influence how patients experience and manage disease. Yet, its relationship with clinical outcomes, mental health, work participation, and broader social factors in inflammatory arthritis remains poorly understood. We discuss the findings from Dr Dey’s large, national cohort study, how we can improve health literacy disparities in patients, and what should be next on the research agenda to tackle this issue.

Click here to read the full article:

https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(26)00081-0/fulltext

In today’s episode Professor Eric Morand discusses the results of Cohort A and Cohort B of the WILLOW trial which investigated the efficacy and safety of enpatoran, a novel, oral small molecule inhibitor of Toll-like receptors 7 and 8 (TLR 7/8) in patients with cutaneous lupus erythematosus (CLE) and systemic lupus erythematosus (SLE). The interferon pathway has been implicated in both CLE and SLE pathogenesis, however, the mechanism through which interferon expression is induced in lupus remains unknown.
Targeting TLR 7/8 is of particular interest, as they are key drivers of interferon activation. Enpatoran has previously shown efficacy in early phase 1 trials of patients with CLE and SLE, with improvements in SLEDAI-2K and reduction in IFN-gene signatures with good safety profiles. We also highlight the differences in study design and endpoints of each cohort, compare and contrast enpatoran to currently approved therapies for SLE, anifrolumab and deucravacitinib, and finally, outline what the next research priority should be for patients with CLE and SLE.

Click here to read the full articles: 
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00337-6/fulltext and https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00463-0/fulltext

In this month’s podcast, we explore Associate Professor Kragstrup’s recent proof-of-concept study which reports glucagon-like peptide-1 (GLP-1) concentrations and dipeptidyl peptidase-4 (DPP-4) activity in paired plasma and synovial fluid from patients with rheumatoid arthritis and spondyloarthritis and discuss whether there may be potential for intra-articular GLP-1 receptor agonist injections in these patients?

GLP-1 receptor agonists are gaining increasing attention in rheumatology due to their immunomodulatory and anti-inflammatory effects, highlighting their role as a potential therapeutic option for patients with rheumatic disease. Whether GLP-1 and DPP-4 (the key regulator of GLP-1) are present in synovial fluid of patients with rheumatic disease and to what extent remains to be seen. Understanding their interplay within the joint may provide more insight on whether GLP-1 receptor agonists could exert direct intra-articular effects in rheumatic disease. We also discuss limitations and barriers of investigating GLP-1 and DPP-4 and the next research priorities for determining the efficacy of GLP-1 receptor agonists in patients with rheumatic disease.

Click here to read the full article: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(26)00074-3/fulltext

In this episode, Professor Dirk Foell from University Hospital Münster unpacks the findings from a recent Europe-wide survey examining trends in paediatric rheumatology care.

Despite significant scientific advances, delivering consistent, high-quality care for children with rheumatic and musculoskeletal diseases remains a challenge. Drawing on Professor Foell's recent Viewpoint, we discuss variation in paediatric rheumatology training pathways, subspecialty accreditation, and professional recognition across Europe, and how these disparities can impact workforce development and clinical care.

Click here to read the full article:
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(25)00378-9/fulltext

As part of The Lancet Rheumatology’s special issue on public and patient involvement in rheumatology, in this month’s episode, Aisling talks to Professor Jon Lampa about his recent publication on the patient-reported outcomes from the NORD-STAR trial.

The 2023 NORD-STAR trial was the first randomised trial to compare three different biological DMARDs, all in combination with methotrexate with active conventional treatment in patients with early rheumatoid arthritis. The study showed that after 48 weeks remission rates were higher in two of the three (Certolizumab pegol, abatacept, but not tocilizumab) biological DMARDs compared to active conventional treatment and that while radiographic progression was low, it was similar between groups. Providing an interesting insight into the management of patients with newly diagnosed rheumatoid arthritis.

Patient-reported outcomes are vital for measuring health, quality of life and treatment impact directly from the patient perspective–and now the data on how these treatments impact patient-reported outcomes is here.
We also discuss the importance of reporting patient-reported outcomes in clinical trials, the benefits of including patients and people with lived experience in research and what the future of patient-reported outcome measures looks like.

Click here to read the full article: https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(26)00007-X/fulltext

Medical imaging and theranostics are revolutionising how we diagnose, treat, and understand disease. To meet this moment, The Lancet group is happy to announce the launch of, The Lancet Medical Imaging and Theranostics. 

You can visit https://www.thelancet.com/medical-imaging-theranostics to learn more.

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