ACR on Air

American College of Rheumatology

As the official podcast of the American College of Rheumatology (ACR), ACR on Air seeks to have informative and engaging conversations rheumatology professionals want to hear – ranging in topic from trends in clinical practice, to issues affecting rheumatology professionals, and the changing landscape of the rheumatology field. Tune in twice a month for engaging interviews and commentary.

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22 episodes
fortnightly
Avg 41 min
English

Episodes 22

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S7 · E133
September 22 · 48 min
How I Treat & Evaluate ILD
Interstitial Lung Disease (ILD) is difficult to diagnose and treat. At first, the disease could look like a variety of other disorders, such as fibrosis or autoimmunity. Once a diagnosis is made, a decision on how aggressively to treat it can mean the difference between irreversible lung damage or overly impacting your patient's quality of life. We caught up with Dr. Robert Hallowell, a Pulmonary and Critical Care physician at the Massachusetts General Hospital and Director of the Interstitial Lung Disease Program at the Pulmonary Ambulatory Clinic. Dr. Hallowell tells us how he evaluates ILD
S7 · E132
September 8 · 44 min
JIA, A Family's Perspective
September is Rheumatic Disease Awareness Month (RDAM), and today we're sharing the story of Deborah Talbot, an occupational therapist from the Children's Hospital of Philadelphia and her daughter, Molly, who was diagnosed with Juvenile Idiopathic Arthritis (JIA) at the age of 12 years old. When an ankle injury turned out to be far more, Molly endured months of pain, swelling, repeated evaluations and the uncertainty of not understanding why she wasn't getting better. This is the story of how a family came together to fight through pain, discover a disease, find remission that would remain for years and start advocacy for those without the resources they were blessed with, emerging triumphant in the face of overwhelming adversity
S7 · E131
August 25 · 36 min
Can We Prevent Rheumatoid Arthritis?
Rheumatoid arthritis may begin years before the first swollen joint appears, with autoantibodies circulating long before a clinical diagnosis is made. In this episode, we explore what happens during this critical preclinical phase and whether RA can be prevented before it starts. Dr. Kevin Dean, director of the Autoimmune Disease Prevention Center at the University of Colorado Anschutz, joins us to discuss what a positive CCP antibody really means, where RA may originate, lessons from the STOP-RA trial, whether we should screen people at risk, and how clinicians should counsel patients who test positive for CCP antibodies.
S7 · E130
August 11 · 44 min
The 2026 Adult/Juvenile Spondyloarthritis Guidelines
The new clinical guidelines for juvenile and adult axial spondyloarthritis (axSpA), developed collaboratively by the American College of Rheumatology (ACR), the Spondylitis Association of America (SAA), and the Spondyloarthritis Research and Treatment Network (SPARTAN), mark an important evolution in the management of this complex disease. In this episode, Drs. Liron Caplan and Matthew Stoll discuss what's changed, why it matters, and how these recommendations can guide everyday clinical practice—from the first-ever juvenile axSpA guideline and the unified approach to radiographic and non-radiographic disease, to practical decisions around MRI use, first-line therapies, biologic selection, treatment failure, and physical activity. 2026 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Axial Spondyloarthritis in Adults and Children/Adolescents
S7 · E129
July 28 · 51 min
Still's Disease and Hyperinflammation
In this episode, Dr. Randy Q. Cron discusses hyperinflammation and Macrophage Activation Syndrome (MAS), one of the most serious complications of Still's disease. Because MAS can mimic infection, sepsis, malignancy, or a disease flare, early recognition is critical—and treatment often must begin before every diagnostic criterion is met. We explore the clinical patterns and laboratory findings that matter most, how to interpret ferritin, and how to make timely decisions when multiple diagnoses may exist at once.
S7 · E128
July 14 · 43 min
Understanding Haploinsufficiency of A20
What if some patients who never quite fit their diagnosis actually have an underlying genetic disorder? In this episode, we explore Haploinsufficiency of A20 (HA20), a condition first described less than a decade ago that is already reshaping our understanding of autoinflammation, autoimmunity, and immune dysregulation. How many patients in our clinics have a genetic diagnosis we've never thought to consider? Join us as we discuss this emerging disease and its clinical implications with Dr. Daniella M. Schwartz.
S7 · E127
June 30 · 50 min
Chronic Inflammatory Calcium Pyrophosphate Arthritis
Could chronic inflammatory calcium pyrophosphate deposition disease (CPPD) be hiding in plain sight? In this episode, we explore why CPPD may be far more common than previously recognized, how it can masquerade as conditions such as refractory inflammatory arthritis, polymyalgia rheumatica, and erosive osteoarthritis, and why it is so often overlooked in clinical practice. We discuss the growing role of musculoskeletal ultrasound in diagnosis and disease management, the structural damage associated with chronic CPPD, and where the field may be headed as researchers pursue more effective treatment strategies.
S7 · E126
June 16 · 50 min
2026 ACR JIA Guidelines: What Clinicians Need to Know
The 2026 ACR Guidelines for Juvenile Idiopathic Arthritis (JIA) are here, and lead author Dr. Karen Onel joins us to unpack the key updates shaping pediatric rheumatology care. From a biologics-first approach in systemic JIA to more individualized treatment pathways for non-systemic disease, the new recommendations emphasize earlier intervention, faster treatment tailoring, and risk-based decision-making. Dr. Onel also discusses the guidelines' broader focus on mental health, physical activity, rehabilitation, and the challenges of growing up with a chronic illness. More than an update to treatment algorithms, these guidelines reflect a fundamental shift in philosophy—one that puts the whole child, not just the diagnosis, at the center of care.
S7 · E125
June 2 · 30 min
Cell Therapy in Rheumatology: CAR-T vs Regulatory T Cells
In the future, can autoimmune disease become curable? A groundbreaking study from Germany suggests there may be a pathway in some cases. Patients with severe, treatment-refractory lupus who received CD19 CAR-T cell therapy have remained in drug-free remission for up to five years without ongoing immunosuppression. In this episode, we discuss how these findings are shifting the conversation from disease control to the possibility of cure, and what they could mean for lupus, inflammatory myopathies, systemic sclerosis, vasculitis, rheumatoid arthritis, and autoimmune diseases more broadly. We also explore CAR-T therapy, immune resets, regulatory T cells, relapse risk, and the future of rheumatology with Dr. Georg Schett.
S7 · E124
May 19 · 29 min
50 Years of Pediatric Rheumatology: A Retrospective
Fifty years ago, pediatric rheumatic disease was often marked by disability, limited treatment options, and low expectations for long-term outcomes. In 1976, a small group of clinicians and scientists helped launch a new understanding of immune-mediated disease in children and laid the foundation for modern pediatric rheumatology. In this episode, we explore how the field evolved from managing chronic disability to expecting remission, transforming both treatment and quality of life for children. We also examine the scientific breakthroughs, models of care, and remaining challenges that continue to shape the future of pediatric rheumatology.
S7 · E123
May 5 · 38 min
VEXAS Syndrome: What You Need to Know
Today, we discuss a new guidance statement from the American College of Rheumatology aimed at bringing much-needed structure to the evaluation and management of patients with VEXAS. This episode breaks down key recommendations, including who should be tested, the best approaches to diagnostic evaluation, how to interpret bone marrow findings, and emerging strategies for treatment—offering clarity in a diagnosis that, until recently, was marked by uncertainty.
S7 · E122
April 21 · 39 min
Support for Private Practice
Private rheumatology practice is contracting under multi-directional pressure: shrinking margins, escalating prior authorizations, tightening Pharmacy Benefit Managers (PBM) and payer restrictions on drug access, and instability across core revenue streams. At the same time, demand is rising, wait times are surging, and workforce shortages are intensifying—driving clinician burnout and retention challenges. This episode is about The American College of Rheumatology's response, in expanding its leadership role in advocacy, health policy reform, and workforce development to help private practices move from survival to sustainable growth.
S7 · E121
April 7 · 50 min
Pericardial Diseases in Rheumatology & Beyond
Pericardial Disease is couched between two medical disciplines: Cardiology and Rheumatology, and those with these conditions visit medical professionals viewing their treatment through one lens or the other. This episode addresses the shifting reality that pericarditis and myocarditis are no longer separate silos but rather takes the broader view of inflammatory heart disease. We'll examine how rheumatologists should be thinking about pericardial disease, when we should get involved, how diagnosis and imaging fit in, plus the evolution of treatment.
S7 · E120
March 24 · 37 min
Current and Evolving Treatments for Myositis
For years, myositis treatment has relied on broad immune suppression with drugs like steroids, methotrexate, and rituximab—but what if we could target the disease more precisely? Inflammatory myopathies are not a single condition, but a group of biologically distinct syndromes with different clinical features and immune pathways. As our understanding evolves, so does the potential for more personalized, targeted therapies. In this episode, we're joined by Dr. Julie J. Paik to discuss how this shift could reshape the future of myositis treatment.
S7 · E119
March 10 · 35 min
Strategies for Workforce Retention
In this episode, we discuss the growing workforce challenges in rheumatology with nurse practitioner Chris Estes. Chris shares how he entered the field, the training he received early in his career, and how he developed expertise in musculoskeletal ultrasound. The conversation explores how advanced practice providers (APPs) can help address rheumatology workforce shortages by expanding access to care—seeing new patients, managing follow-ups, and working both collaboratively and independently within a practice. Chris also discusses training pathways for new APPs, common misconceptions practices may have, and how investing in APP development may be an important strategy for the future of rheumatology care.
S7 · E118
February 24 · 45 min
The Next Era of Gout Therapy
In this episode, we explore the paradox of gout—one of the most biologically understood and treatable diseases in medicine, yet still among the most poorly controlled chronic conditions in practice. With effective therapies readily available, why do patients continue to cycle through painful flares, start and stop medications, and return to clinics and hospitals in a pattern that feels like a recurring failure? We unpack the complex interplay between biology, patient behavior, medication adherence, and health system barriers, asking whether the problem lies in the disease itself or in how care is delivered. As new treatments emerge, we also question whether innovation alone can solve the problem—or whether lasting change requires fixing the systems struggling to fully use the tools already at hand.
S7 · E117
February 10 · 39 min
Precision Rheumatology, APS and You
In this episode, we explore Antiphospholipid Syndrome (APS) with Dr. Yu (Ray) Zuo, beginning with a clear, clinically grounded explanation before diving into the personal and scientific journey that drew him to this notoriously complex disease. Along the way, Dr. Zuo shares a case that forever changed how he understands APS, then takes us inside his latest Arthritis & Rheumatology study, where machine learning reveals hidden patterns that may reshape how we think about patients and risk. The conversation moves from bedside to bench and back again, tackling what AI can—and can't—do for rheumatology, where APS research is headed next, and what early investigators need to know to build impactful careers.
January 27 · 37 min
The Year Ahead for The ACR with Dr. Will Harvey
In this episode, we sit down with Dr. William Harvey, the newly appointed President of the American College of Rheumatology and a dedicated volunteer of nearly 20 years. Dr. Harvey shares what it's like stepping into the presidency, the key priorities shaping the year ahead, and how the ACR is approaching strategy, advocacy, partnerships, and leadership during this pivotal moment for the field.
S7 · E115
January 13 · 55 min
The Evaluation and Management of Osteoporosis
In this episode, our expert guest challenges a common assumption by explaining why the T-score—despite being central to osteoporosis diagnosis—is surprisingly easy to misinterpret. He walks us through how to read a DEXA scan like a detective, highlighting subtle clues that can dramatically improve diagnostic accuracy for your patients. Once osteoporosis is identified, the conversation turns to clinical decision-making: how to choose between anabolic agents, denosumab, and bisphosphonates, and why that choice depends on thoughtful risk stratification and patient-specific comorbidities. We also dive into the often-overlooked importance of sequencing osteoporosis medications correctly, including a compelling discussion on why starting with an anabolic agent may offer greater long-term benefits than reserving it as a last-line option.
S6 · E114
Dec 16, 2025 · 50 min
Degos Disease
In this episode, we explore malignant atrophic papulosis—also known as Degos disease—an extraordinarily rare microvascular disorder so uncommon that most clinicians will never see a single case. For decades, medical literature labeled it "uniformly fatal." Our guest, Dr. Lee Shapiro, encountered this reality when he began treating a rapidly deteriorating 16-year-old boy with no clear treatment path. Driven by urgency, he reached out to experts across the country, slowly piecing together clues that ultimately led to the first successful treatment of systemic Degos disease. Today, Dr. Shapiro is a leading advocate for patients, connecting a global community, promoting early recognition, and working tirelessly to expand access to life-saving therapies. Learn more at The Degos Disease Foundation

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