MD Newsline

Welcome to The MD Newsline Podcast, where we bring you the latest insights at the intersection of healthcare and innovation. Join us as we dive deep into the medical breakthroughs, clinical trial updates, and industry best practices shaping the future of patient care. Each episode features thought-provoking conversations with leading healthcare professionals, researchers, and advocates tackling the biggest challenges in medicine today. We uncover the strategies and innovations that are transforming the way care is delivered. If you're a healthcare provider, industry leader, or simply passionate about advancing medical education, this is your go-to resource for expert knowledge and actionable insights. Tune in, stay informed, and be part of the movement toward a healthier future.

Non-Radiographic Axial SpA: X-Rays, Referral, and Biologics with Dr. Iqra Aftab 08/12/2026

Non-Radiographic Axial SpA: X-Rays, Referral, and Biologics with Dr. Iqra Aftab In this episode of MD Newsline, Dr. Iqra Aftab, a double board-certified rheumatologist and internal medicine physician, offers a practical guide to recognizing, diagnosing, and managing axial spondyloarthritis (axial SpA), with a particular focus on non-radiographic disease. She explains why axial SpA can be overlooked in younger patients with persistent back pain and how clinicians can recognize inflammatory patterns even when conventional imaging appears normal. Dr. Aftab walks through the spondyloarthritis spectrum, distinguishing radiographic axial SpA from non-radiographic axial SpA and emphasizing that the absence of joint damage on X-rays does not mean the disease is mild or insignificant. She highlights clinical clues such as morning stiffness, improvement with exercise and anti-inflammatories, and younger age, while also discussing extra-articular manifestations including uveitis, psoriasis, and inflammatory bowel disease. The conversation also explores the appropriate role of X-rays and MRI, the distinction between classification and diagnostic criteria, treatment escalation from NSAIDs to biologic and targeted therapies, and how extra-articular disease can influence treatment selection. Dr. Aftab addresses fatigue, functional impairment, lifestyle management, multidisciplinary care, and the importance of early rheumatology referral to reduce diagnostic delays. Episode Highlights: Recognizing Inflammatory Back Pain: Dr. Aftab explains the key features that can distinguish inflammatory from mechanical back pain, including morning stiffness, improvement with exercise and anti-inflammatories, and younger age. Understanding Non-Radiographic Axial SpA: A normal X-ray does not rule out axial SpA. Dr. Aftab emphasizes that non-radiographic disease can still cause significant pain, disability, and reduced quality of life. Recognizing Extra-Articular Manifestations: Uveitis, psoriasis, and inflammatory bowel disease can provide important clues to an underlying spondyloarthritis diagnosis. Choosing Imaging and Treatment: The discussion covers when to move from X-rays to MRI and when to escalate from NSAIDs to biologic or targeted therapies. Matching Therapy to the Patient: Dr. Aftab explains how extra-articular disease, treatment risks, patient preferences, and practical considerations can influence biologic selection and treatment changes. Addressing Fatigue and Daily Function: Fatigue may stem from active inflammation or other factors, while assessing work, family life, and daily activities can reveal the true impact of disease. Knowing When to Refer: Persistent back pain with inflammatory features in a younger patient should prompt rheumatology referral, even when X-rays are normal or the diagnostic workup is incomplete. Key Takeaway: Dr. Aftab emphasizes that a normal X-ray does not rule out non-radiographic axial SpA. Recognizing inflammatory back pain, considering appropriate imaging, connecting extra-articular symptoms, and referring patients early can help reduce diagnostic delays and support timely treatment. Resources: Website: Newsletter: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/42412495

Beyond Dryness: Recognizing and Managing Sjögren’s Syndrome in Everyday Care 06/30/2026

Beyond Dryness: Recognizing and Managing Sjögren’s Syndrome in Everyday Care In this episode of MD Newsline, Dr. Hina Tareen, a double board-certified rheumatologist and internal medicine physician, provides a comprehensive and practical guide to diagnosing and managing Sjögren’s syndrome in everyday clinical practice. Drawing from her experience in private practice, she highlights the challenges of recognizing this often-overlooked autoimmune condition and emphasizes the importance of early suspicion and multidisciplinary care. Dr. Tareen walks through the hallmark symptoms of Sjögren’s, including dry eyes and dry mouth, while underscoring the broader systemic nature of the disease. She discusses how to differentiate clinically significant disease from common dryness complaints, outlines a step-by-step diagnostic framework, and explores management strategies ranging from symptomatic relief to systemic immunosuppressive therapy. The conversation also addresses common pitfalls in diagnosis, the role of collaboration across specialties, and the importance of patient education and long-term monitoring. With emerging research on novel biomarkers and evolving treatment options, this episode offers valuable insights for clinicians navigating the complexities of Sjögren’s syndrome. Episode Highlights: Recognizing Early Signs of Sjögren’s Syndrome Dr. Tareen explains that persistent dry eyes and dry mouth are the most common presenting symptoms, but clinicians must also look beyond dryness to identify fatigue, joint pain, and systemic features. Distinguishing Sjögren’s from Benign Dryness Clinical context is key—frequent use of artificial tears, difficulty swallowing dry foods, and associated systemic symptoms help differentiate Sjögren’s from more common causes of dryness. Primary vs Secondary Sjögren’s Syndrome Sjögren’s often coexists with other autoimmune diseases like rheumatoid arthritis and lupus. Identifying whether the disease is primary or secondary is essential for guiding management. Diagnostic Approach and Laboratory Evaluation A thorough history and physical exam remain foundational. Key labs include ANA, ENA panel, inflammatory markers, complement levels, and organ function tests, with biopsy reserved for unclear cases. Managing Seronegative or Atypical Cases Patients who do not meet full criteria may still be treated based on clinical suspicion. Additional testing, including salivary gland biopsy, may help confirm the diagnosis when necessary. Assessing and Monitoring Systemic Involvement Clinicians must remain vigilant for extra-glandular manifestations, including renal, pulmonary, neurologic, and hematologic involvement, which may require imaging, lab monitoring, and specialist referrals. Stepwise Treatment Strategy Management begins with symptomatic relief for dryness, followed by systemic therapy such as hydroxychloroquine, methotrexate, or mycophenolate based on organ involvement and disease severity. Addressing Fatigue and Quality of Life Fatigue is often multifactorial. Dr. Tareen emphasizes evaluating sleep, mood, nutritional deficiencies, and overall disease control to improve patient outcomes. Long Diagnostic Journeys and Missed Opportunities Many patients experience years of symptoms before diagnosis due to vague presentations. Increasing awareness among clinicians can help reduce delays and improve care. Lymphoma Risk and Long-Term Monitoring While Sjögren’s carries an increased lymphoma risk, careful monitoring through labs and clinical evaluation helps identify higher-risk patients and guide timely referrals. Patient Education and Self-Management Hydration, eye and dental care, and lifestyle modifications play a crucial role. Empowering patients with knowledge helps them better manage their condition and advocate for their care. Future Directions in Sjögren’s Research Emerging biomarkers and new therapeutic options are on the horizon, offering hope for earlier diagnosis and more targeted treatment strategies. Key Takeaway: Dr. Tareen emphasizes that Sjögren’s syndrome is a complex, systemic autoimmune disease that often presents subtly. Early recognition, a thorough clinical approach, and multidisciplinary collaboration are essential to improving patient outcomes and preventing long-term complications. Resources: Website: Newsletter: Contact with Dr. Hina Tareen: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/40581915

Beyond Back Pain: Recognizing and Treating Axial Spondyloarthritis Early 06/16/2026

Beyond Back Pain: Recognizing and Treating Axial Spondyloarthritis Early In this episode of MD Newsline, Dr. Jill Weintraub, founder of Integrative Rheumatology Consultants, explores the complexities of axial spondyloarthritis, a chronic inflammatory condition that often goes undiagnosed for years. Dr. Weintraub provides a comprehensive overview of this umbrella disease, including its radiographic and non-radiographic forms, and explains why early recognition is critical to preventing long-term damage. She highlights the key differences between inflammatory and mechanical back pain, the challenges in diagnosing women, and the role of advanced imaging such as MRI. The conversation also dives into the interplay between genetics, the gut microbiome, and immune system dysfunction, as well as how modern therapies—from TNF inhibitors to JAK inhibitors—are transforming patient outcomes. Dr. Weintraub emphasizes the importance of integrating lifestyle interventions like exercise and physical therapy alongside medical treatment to improve long-term quality of life. Episode Highlights: Understanding Axial Spondyloarthritis Dr. Jill Weintraub explains axial spondyloarthritis as an umbrella of inflammatory diseases primarily affecting the spine, while also involving joints and entheses. She distinguishes between radiographic (ankylosing spondylitis) and non-radiographic forms, emphasizing how evolving definitions are improving diagnosis. Recognizing Inflammatory Back Pain A key diagnostic feature is inflammatory back pain, typically presenting before age 40 with morning stiffness that improves with movement. Dr. Weintraub contrasts this with mechanical back pain and highlights why this distinction is critical in clinical practice. Diagnostic Challenges and Delays Diagnosis can take years, especially in women, due to atypical presentations and central sensitization of pain. She stresses the importance of patient advocacy and clinician awareness to reduce delays. Role of Imaging and Clinical Evaluation MRI of the pelvis with appropriate sequences is essential for early detection, particularly in non-radiographic disease. However, Dr. Weintraub underscores that diagnosis remains largely clinical, as lab markers may often appear normal. Genetics, Microbiome, and Immune Interplay The episode explores how genetic factors like HLA-B27, combined with environmental triggers and gut microbiome imbalances, contribute to disease development and progression. Treatment Strategies and Biologic Selection Dr. Weintraub discusses how treatment is tailored to the whole patient, comparing TNF inhibitors, IL-17 inhibitors, and JAK inhibitors, while weighing risks such as infection, cardiovascular events, and long-term safety. Importance of Exercise and Integrative Care Exercise, physical therapy, and lifestyle interventions are essential components of treatment. While supplements and diet can support symptom relief, they are not substitutes for disease-modifying therapies. Managing Overlapping Conditions She highlights the importance of coordinating care for patients with related conditions such as psoriasis, uveitis, and inflammatory bowel disease, ensuring treatment choices address multiple disease pathways. Future Directions in Research Emerging research on the gut microbiome offers promising insights into new therapeutic targets, potentially transforming how axial spondyloarthritis is managed in the future. Key Takeaway Early recognition of inflammatory back pain is critical in axial spondyloarthritis. A combination of clinical awareness, appropriate imaging, and personalized treatment—including both pharmacologic and lifestyle approaches—can significantly improve patient outcomes and prevent long-term disease progression. Resources Website: Newsletter: Contact with Dr. Jill Weintraub: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/40581760

Addiction, Overstimulation, and Performance in Sports Psychiatry 05/19/2026

Addiction, Overstimulation, and Performance in Sports Psychiatry In this episode of MD Newsline, Dr. Justin Morales, Addiction Psychiatry Fellow at Mass General Brigham Harvard Medical System, explores how our understanding of addiction has evolved from a simple reward-pathway model to a comprehensive biopsychosocial framework. Dr. Morales discusses substance use disorders alongside emerging behavioral addictions such as social media overuse, gaming, and binge behaviors. He explains how dopamine signaling, reward-based learning, and executive function circuits influence compulsivity and craving—and why modern overstimulation may blur the line between habit and addiction. The conversation also examines cannabis potency trends, co-occurring psychiatric conditions, sports psychiatry, and emerging neuromodulation treatments for addiction. Episode Highlights: The Biopsychosocial Model of Addiction Dr. Morales outlines the shift from a narrow neurochemical model to a holistic framework incorporating biology, psychology, and social environment. Treatment may involve medication, therapy, and social interventions working together rather than in isolation. Substance vs. Behavioral Addictions While behavioral addictions like social media overuse are not formally classified the same way as substance use disorders in DSM-5, clinicians can adapt similar criteria—such as functional impairment, compulsivity, and high-risk behaviors—to assess severity. Cannabis Potency and Psychiatric Risk Modern cannabis products are significantly more potent than in prior decades. Dr. Morales highlights growing concerns about high-THC exposure potentially contributing to psychosis and mood destabilization. Co-Occurring Mood Disorders Over half of individuals with substance use disorders have a co-occurring psychiatric condition. Dr. Morales discusses common treatment pitfalls—such as addressing depression without addressing substance use—and emphasizes integrated care. Digital Overstimulation and Dopamine Social media and gaming platforms leverage reward-based learning similar to substances. The brain adapts to chronic overstimulation, which may lead to reduced baseline motivation and mood flattening. Dopamine Detox: Myth or Medicine? Although strong research evidence is limited, reducing overstimulation may help the brain recalibrate toward homeostasis and improve natural reward sensitivity. Integrated Treatment for Multiple Addictions Dr. Morales explains how clinicians may treat different substances pharmacologically while addressing underlying psychological drivers—such as avoidance or emotional numbing—through unified therapy strategies. Sports Psychiatry and Identity Athletes face unique pressures tied to performance, injury, career transitions, and identity fusion. Substance use and mood disorders may emerge during times of injury or role changes. Youth Sports and Escalating Pressure With increasing financial and performance stakes at younger ages, adolescent athletes face heightened mental health risk before full neurodevelopment. Neuromodulation in Addiction Emerging treatments—including transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), and vagus nerve stimulation (VNS)—target brain circuits involved in executive function and craving, particularly the prefrontal cortex. Executive Function and Craving Addiction involves planning, coordination, and decision-making processes—not simply impulsivity. Targeting prefrontal control circuits may influence compulsive behaviors and substance-seeking. Collaborative Care Model Effective addiction and sports psychiatry care requires collaboration among psychiatrists, psychologists, social workers, trainers, coaches, and family members to identify behavioral changes early and provide coordinated support. Key Takeaway Addiction in the modern era extends beyond substances to include digital and behavioral reinforcers embedded in everyday life. A biopsychosocial framework—combined with integrated treatment, executive function support, and collaborative care—offers the most effective approach for addressing substance use disorders and behavioral addictions alike. Resources: Website: Newsletter: Contact with Dr. Justin Morales: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/40223990

Beyond Statins: Modern Cholesterol Care, Risk Assessment, and the Future of Lipid Therapy 03/17/2026

Beyond Statins: Modern Cholesterol Care, Risk Assessment, and the Future of Lipid Therapy In this episode of MD Newsline, Dr. Amber Johnson, Assistant Professor of Medicine and General Cardiologist at the University of Chicago, provides an in-depth look at modern cholesterol management and cardiovascular risk reduction. She discusses evolving lipid guidelines, aggressive LDL-C targets, statin intolerance, and the growing role of non-statin therapies. Dr. Johnson also explores emerging research on lipoprotein(a), hypertriglyceridemia, and future directions in lipid-lowering treatment. Episode Highlights Evolving Cholesterol Management and ASCVD Risk Dr. Johnson explains how cholesterol treatment has become more aggressive over the past decade, driven by robust evidence linking LDL cholesterol to cardiovascular events. She emphasizes LDL-C as the primary treatment target and discusses the role of HDL, triglycerides, and inflammatory markers such as high-sensitivity CRP, particularly in women. Lifestyle Modification and Population-Level Prevention Heart-healthy lifestyle interventions remain foundational to cardiovascular prevention. Dr. Johnson highlights the American Heart Association’s Life’s Essential Eight, including physical activity, diet, sleep, and smoking cessation, as critical components of long-term risk reduction. Key Updates in 2025 Dyslipidemia Guidelines Dr. Johnson reviews the 2025 ESC/EAS-focused update, emphasizing lower LDL-C targets for high- and extreme-risk patients. She discusses the increasing use of PCSK9 inhibitors, adjunct lipid-lowering therapies, and the recommendation for routine lipoprotein(a) screening as a risk-modifying factor. Risk Assessment and Personalized Treatment Decisions For primary prevention patients, Dr. Johnson outlines how risk calculators, coronary artery calcium scoring, and comorbidities such as diabetes and metabolic syndrome guide lipid-lowering intensity. She also addresses how updated endocrine and diabetes guidelines influence earlier and more aggressive treatment strategies. Statin Intolerance and Treatment Sequencing Persistent barriers to statin use include side effect concerns, cost, and polypharmacy. Dr. Johnson shares practical strategies for managing statin intolerance, including dose adjustments, switching statins, alternate-day dosing, and the addition of non-statin therapies such as ezetimibe, bempedoic acid, and PCSK9 inhibitors. Non-Statin Therapies and New Treatment Options Dr. Johnson discusses when to escalate therapy to PCSK9 inhibitors, including monoclonal antibodies and siRNA-based agents like inclisiran. She also explains how cost, access, and insurance coverage influence real-world treatment decisions. Triglycerides and Emerging Lipid Targets While triglycerides are often overlooked, Dr. Johnson reviews their clinical significance, particularly in severe hypertriglyceridemia. She discusses lifestyle interventions, fibrates, omega-3 therapies, and emerging agents targeting ANGPTL3 and APOC-3. The Role of Lipoprotein(a) Routine Lp(a) screening is gaining momentum due to its strong association with cardiovascular disease and aortic stenosis. Dr. Johnson reviews current guideline recommendations, clinical utility, and ongoing outcome trials such as OCEAN and HORIZON that may soon reshape treatment options. Special Populations and Complex Care Dr. Johnson addresses lipid management in patients with chronic kidney disease, HIV, inflammatory diseases, and cancer, emphasizing individualized therapy and careful consideration of drug–drug interactions. Future Directions in Lipid Therapy Looking ahead, Dr. Johnson explores long-acting therapies and gene-editing approaches such as CRISPR, while highlighting the importance of health equity, access to care, and sustainable lifestyle interventions. Key Takeaway Dr. Johnson underscores that lower LDL cholesterol is better, with no identified lower limit of harm, and highlights the growing importance of lipoprotein(a) screening in cardiovascular risk assessment. As lipid therapies continue to evolve, combining guideline-driven care, patient-centered decision-making, and equitable access remains essential to improving long-term cardiovascular outcomes. Resources Website: Newsletter: Contact with Dr. Amber Johnson: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/40027185

Understanding Alzheimer’s Disease: Biomarkers and Early Detection 03/03/2026

Understanding Alzheimer’s Disease: Biomarkers and Early Detection In this episode of MD Newsline, Dr. Rudolph J. Castellani, a neuropathologist and Director of the Division of Neuropathology at Northwestern University, offers a deep dive into the biology, diagnosis, and ongoing controversies surrounding Alzheimer’s disease. He explores how Alzheimer’s is defined clinically and pathologically, the evolving role of biomarkers in early detection, and why modifying biomarkers has not yet translated into meaningful clinical improvement for patients. Dr. Castellani also discusses the promise and limitations of artificial intelligence, personalized medicine, and lifestyle interventions in Alzheimer’s research and care. Episode Highlights Defining Alzheimer’s Disease Dr. Castellani explains how Alzheimer’s disease can be defined clinically—through progressive memory and cognitive decline—or pathologically, based on hallmark brain lesions such as amyloid plaques and neurofibrillary tangles identified post-mortem. These structural changes remain central to diagnosis but do not fully explain disease progression. The Role of Amyloid and Biomarkers Amyloid beta, a key component of senile plaques, can now be detected through cerebrospinal fluid testing, blood-based biomarkers, and PET imaging. Dr. Castellani discusses how biomarkers help identify disease presence earlier but raises important questions about whether amyloid is a driver of disease or merely an associated marker. Early Detection: Promise and Ethical Concerns While biomarkers allow detection before symptoms appear, Dr. Castellani highlights the ethical dilemma of diagnosing asymptomatic individuals. He questions whether early identification without effective intervention may increase anxiety without improving outcomes. Therapies and Clinical Trial Limitations New anti-amyloid therapies, including FDA-approved agents, show only marginal cognitive benefit in highly selected trial populations. Dr. Castellani emphasizes caution when extrapolating these results to broader, more diverse patient groups and underscores the potential risks and toxicities associated with these treatments. Artificial Intelligence and Predictive Modelling AI and machine learning may enhance predictive modeling by integrating biomarkers, genetics, and cognitive data. However, Dr. Castellani notes that prediction alone is insufficient without therapies that meaningfully alter disease progression. Age of Onset and Risk Factors Alzheimer’s disease can present as early as a patient’s 30s in rare genetic cases or later in life in sporadic forms. Dr. Castellani reviews known risk factors, including APOE genotype, hypertension, diabetes, hearing loss, and traumatic brain injury, while stressing that many associations remain poorly understood. Personalized Medicine and Genetic Counseling Genetic testing—particularly for APOE and pathogenic mutations—plays a role in personalized risk assessment. Dr. Castellani emphasizes the importance of careful counseling, as not all individuals want or benefit from knowing their genetic risk. Supportive and Interdisciplinary Care With no curative treatments available, interdisciplinary care involving neurologists, neuropsychologists, and social workers is essential. Dr. Castellani highlights the importance of caregiver support, expectation management, and access to specialized centers. Lifestyle and Prevention Although lifestyle changes may not alter the underlying biology of Alzheimer’s disease, healthy diet, exercise, and reducing inflammation and oxidative stress can improve quality of life and overall health. Key Takeaway Dr. Castellani underscores that while biomarkers and amyloid-focused therapies dominate current Alzheimer’s research, they have not yet delivered meaningful clinical improvement. A broader research approach—beyond amyloid—combined with realistic expectations, ethical care, and strong support systems is essential for patients and families navigating Alzheimer’s disease. Resources MD Newsline Website: Newsletter: Contact with Dr. Rudolph J. Castellani: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/40027120

Innovation, Access, and the Future of Cardiac Care 02/03/2026

Innovation, Access, and the Future of Cardiac Care In this episode of MD Newsline, Dr. Quentin Youmans, a heart failure cardiologist at Northwestern Medicine, explores the rapidly evolving landscape of advanced heart failure care. He shares insights into guideline-directed medical therapy, emerging device-based interventions, and the growing role of personalized medicine in improving outcomes for patients with complex cardiovascular disease. Dr. Youmans also addresses health disparities, access challenges, and the importance of multidisciplinary collaboration in modern cardiology. Episode Highlights Advances in Guideline-Directed Medical Therapy (GDMT) Dr. Youmans discusses the four pillars of GDMT for heart failure with reduced ejection fraction and how rapid initiation and optimization of therapy can significantly improve patient outcomes. He emphasises early sequencing, close follow-up, and collaboration with pharmacy teams to ensure patients receive maximal benefit. Device-Based Therapies in Advanced Heart Failure Innovations such as transcatheter mitral valve repair, pulmonary artery pressure monitoring, and advanced hemodynamic devices are reshaping heart failure care. Dr. Youmans explains how these technologies help reduce hospitalizations, improve symptoms, and support earlier intervention in high-risk patients. Health Disparities and Access to Care A major focus of the conversation centers on racial, socioeconomic, and geographic disparities in heart failure outcomes. Dr. Youmans highlights efforts to expand access through community-based clinics, telehealth, and outreach to rural and underserved populations. Sex-Based Differences and Cardiovascular Risk Across the Lifespan Dr. Youmans explores how pregnancy-related conditions such as preeclampsia increase long-term cardiovascular risk for women. He underscores the need for coordinated care between cardiology, OB-GYN, and primary care to support prevention and long-term monitoring. Multidisciplinary and Collaborative Care Models Heart failure management increasingly relies on collaboration across specialties, including nephrology, endocrinology, interventional cardiology, and surgery. Dr. Youmans discusses how integrated care models improve decision-making and patient outcomes, particularly in complex cases involving CKM (cardiovascular-kidney-metabolic) syndrome. Personalized Medicine and Biomarkers Biomarkers such as BNP play a growing role in risk stratification and treatment monitoring. Dr. Youmans explains how future approaches may tailor therapies based not only on biology, but also on patients’ social environments and barriers to care. Emerging Therapies and the Future of Heart Failure Treatment From SGLT2 inhibitors and GLP-1 receptor agonists to new mineralocorticoid receptor antagonists, Dr. Youmans reviews promising pharmacologic advances for both HFrEF and HFpEF. He also shares perspectives on future innovations, including fully implantable LVADs, organ preservation technologies, and transplant expansion strategies. Key Takeaway Dr. Youmans emphasizes that the future of heart failure care lies at the intersection of innovation, equity, and collaboration. By combining advanced therapies with patient-centered communication and improved access, clinicians can meaningfully transform outcomes for diverse patient populations. Resources Website: Newsletter: Connect with Dr. Quentin Youmans: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/39757280

Axial Spondyloarthritis: From Inflammatory Back Pain to Targeted Therapy 01/06/2026

Axial Spondyloarthritis: From Inflammatory Back Pain to Targeted Therapy In this episode of MD Newsline, Dr. Joel Wright, a rheumatology fellow at UCLA, provides an in-depth, practical discussion on axial spondyloarthritis and related spondyloarthritides. Dr. Wright breaks down evolving disease definitions, diagnostic challenges, imaging interpretation, and modern treatment strategies, while emphasizing a holistic, patient-centered approach to care. The conversation highlights how early recognition and individualized therapy can significantly improve long-term outcomes. Episode Highlights Defining Axial vs. Peripheral Spondyloarthritis Dr. Wright explains the modern classification of spondyloarthritis, distinguishing axial disease—which primarily affects the spine and sacroiliac joints—from peripheral spondyloarthritis and psoriatic arthritis. He discusses why the shift away from the term ankylosing spondylitis allows for earlier diagnosis before irreversible spinal fusion occurs. Recognizing Red Flags Across Specialties Inflammatory back pain remains the most important clinical clue, particularly pain that worsens at rest, improves with exercise, and is associated with prolonged morning stiffness. Dr. Wright also highlights extra-musculoskeletal signs—such as uveitis, psoriasis, and inflammatory bowel disease—that should prompt early referral to rheumatology. Classification Criteria vs. Clinical Judgment While ASAS classification criteria are useful for research, Dr. Wright emphasizes that real-world diagnosis relies on clinical expertise. Patients may not meet strict criteria early in the disease course, yet still warrant diagnosis and treatment based on symptoms, exam findings, labs, and imaging. MRI Use and Common Diagnostic Pitfalls MRI of the sacroiliac joints plays a central role in early detection, but Dr. Wright cautions against overreliance on imaging alone. Bone marrow edema can be seen in athletes, postpartum patients, or with aging, underscoring the importance of correlating MRI findings with clinical context. Biomarkers and Emerging Research HLA-B27, ESR, and CRP remain useful tools, though many patients have normal inflammatory markers. Dr. Wright discusses emerging biomarkers, including antibodies such as anti-CD74, and the need for more reliable tools to support earlier diagnosis. Treatment Algorithms and Medication Selection NSAIDs remain first-line therapy and may slow radiographic progression. For patients with inadequate response, Dr. Wright outlines escalation to biologics, including TNF inhibitors, IL-17 inhibitors, and JAK inhibitors—while tailoring choices based on comorbidities such as uveitis or inflammatory bowel disease. Treat-to-Target and Monitoring Early disease requires more frequent follow-up to assess response and adjust therapy. Dr. Wright explains realistic timelines for evaluating NSAIDs and biologics while balancing treat-to-target goals with clinic capacity. The Role of Exercise and Non-Pharmacologic Care Physical therapy, structured exercise, and low-impact activities such as swimming and cycling are foundational to care. Dr. Wright emphasizes the mental and physical benefits of movement, posture training, and holistic therapies alongside medication. Managing Comorbidities and Special Populations The discussion covers cardiovascular risk screening, adherence challenges in younger patients, biologic tapering in remission, pregnancy considerations, and care for older adults with established structural damage. Shared decision-making remains central across all scenarios. Key Takeaway Dr. Wright underscores that axial spondyloarthritis requires early recognition, thoughtful interpretation of imaging, and individualized treatment strategies. Combining pharmacologic therapy with exercise, multidisciplinary care, and patient education is essential to improving quality of life and preventing long-term disability. Resources Website: Newsletter: Connect with Dr. Joel Wright: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/39623405

Vitamin D, Epstein-Barr Virus, and MS Risk 01/06/2026

Vitamin D, Epstein-Barr Virus, and MS Risk In this episode of MD Newsline, Dr. Marianna Cortese, a medical doctor and epidemiologist at the Harvard T.H. Chan School of Public Health, shares groundbreaking research on the link between vitamin D, Epstein-Barr virus (EBV), and the risk of multiple sclerosis (MS). Her work, conducted within the U.S. military cohort, sheds new light on racial, genetic, and environmental factors influencing MS development and potential prevention strategies. Dr. Cortese discusses how vitamin D levels and immune response modulation play a role in MS prevention, and how EBV infection—now recognized as the leading cause of MS—interacts with genetic susceptibility and immune regulation. She also explores the future of AI in epidemiological research, the challenges of defining “deficiency” across diverse populations, and how personalized medicine may change MS prevention and treatment. Episode Highlights Understanding the Vitamin D–MS Connection Dr. Cortese explains her landmark study assessing vitamin D levels in over 1,400 MS cases and double the number of controls from a U.S. military cohort. The findings show that higher vitamin D levels are associated with a 60% lower risk of MS, even among individuals who already meet current “sufficient” vitamin D thresholds. Epstein-Barr Virus as a Causal Factor She details how EBV infection precedes nearly all MS diagnoses, increasing risk 32-fold in those infected compared to those who remain uninfected. The 2022 Science paper by her team was pivotal in confirming EBV as the primary cause of MS. Racial and Genetic Differences in Vitamin D Physiology Dr. Cortese emphasizes that Black populations may metabolize vitamin D differently, which could explain why prior studies found weaker associations between vitamin D levels and MS risk. Her ongoing work includes genotyping vitamin D transport proteins and analyzing ethnic variations in MS susceptibility. Public Health Implications and Future Research Given vitamin D’s safety, affordability, and widespread deficiency, Dr. Cortese advocates for revised supplementation guidelines tailored to disease prevention. She also highlights future research directions involving AI-driven data analysis, omics studies, and therapeutic vaccines or antivirals targeting EBV. A Look Toward MS Prevention and Treatment Dr. Cortese envisions a future where antiviral therapies against EBV could transform MS management—potentially leading to disease-modifying or curative interventions. Meanwhile, maintaining sufficient vitamin D remains a key, accessible step for reducing risk. Key Takeaway Dr. Cortese’s research bridges decades of inquiry into how vitamin D and EBV intersect to influence MS risk. Her findings reinforce the importance of immune health, genetic understanding, and early prevention, paving the way for more personalized and equitable approaches to neurological care. Resources Website: Newsletter: Connect with Dr. Marianna Cortese: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/38903890

Living With HS: Tameka Carter’s Journey to Diagnosis and Treatment 01/02/2026

Living With HS: Tameka Carter’s Journey to Diagnosis and Treatment In this episode of MD Newsline, patient advocate Tameka Carter shares her personal journey living with hidradenitis suppurativa (HS), a chronic, painful inflammatory skin condition often misdiagnosed for years. Tameka discusses the early signs of HS, the emotional and physical toll of delayed diagnosis, and the importance of finding a specialist who truly listens. She offers valuable insight into treatment decision-making, lifestyle changes, and the critical role of self-advocacy in managing a lifelong condition. Episode Highlights Early Symptoms and Delayed Diagnosis Tameka reflects on experiencing painful boils as early as adolescence, often dismissed as razor bumps, cysts, or irritation. Despite recurring symptoms, she did not receive an HS diagnosis until 2019—highlighting a common challenge many HS patients face. Impact of Hormones and Life Changes Symptoms became more frequent and severe in her early 20s, particularly after pregnancy. Over time, Tameka began noticing patterns related to her menstrual cycle, helping her better understand flare triggers. The Emotional and Physical Burden of HS Living with chronic pain, drainage, and scarring significantly affected Tameka’s quality of life and confidence. She shares how unmanaged HS can quietly take over daily living when symptoms become constant. Finding the Right Specialist Tameka emphasizes the turning point in her care after seeking a dermatologist who specializes in HS. Under the care of Dr. Onajin, she experienced a more aggressive, responsive treatment approach that prioritized real pain reduction and patient feedback. Personalized Treatment and Pain Measurement Rather than a one-size-fits-all approach, treatment success was measured by meaningful pain reduction percentages. This patient-centered strategy allowed Tameka and her care team to adjust therapies quickly when something wasn’t working. Procedures, Medications, and Combination Care Tameka discusses the role of biologics, steroid injections, surgical procedures, and scar tissue removal as part of a comprehensive treatment plan—emphasizing that improvement was gradual, not overnight. Nutrition and Lifestyle as Key Triggers Diet emerged as one of the most impactful factors in managing HS. Tameka shares how eliminating refined sugar, dairy, and soda helped reduce flares, improve energy levels, and support overall well-being. Advocacy, Education, and Listening to Your Body A strong advocate for patient education, Tameka encourages others to research their condition, speak up when treatments fail, and seek second or third opinions. She underscores that patients know their bodies best—and deserve to be heard. Advice for Patients and Providers Tameka offers powerful guidance for those living with HS and for healthcare providers: listen, communicate clearly, and treat patients as partners in care. Key Takeaway Tameka Carter’s story highlights the importance of early recognition, specialist care, and patient advocacy in managing hidradenitis suppurativa. Meaningful progress happens when patients are heard, treatments are personalized, and care teams act with urgency and compassion. Resources Website: Newsletter: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/39589855

How Ultra-Processed Food Impacts MS Progression 12/30/2025

How Ultra-Processed Food Impacts MS Progression In this episode of MD Newsline, Dr. Gloria Dalla Costa, a researcher at Harvard University, shares groundbreaking insights into the role of ultra-processed foods in multiple sclerosis (MS) progression. Drawing from her research on environmental and metabolic risk factors, Dr. Dalla Costa discusses how dietary habits may influence inflammation, disease activity, and long-term neurological outcomes in MS patients. Her work reveals compelling evidence that higher consumption of ultra-processed foods correlates with increased inflammatory markers, worsened MRI outcomes, and a greater risk of relapse. By analyzing blood-based metabolic signatures, her team is uncovering how these foods interact with biological pathways tied to chronic inflammation and neurodegeneration. Dr. Dalla Costa also discusses the Nova classification of processed foods, the role of ceramides and other metabolites in cellular health, and how regional dietary patterns affect disease outcomes. She emphasizes the importance of adopting a Mediterranean-style diet and reducing ultra-processed food intake as a modifiable lifestyle factor that can complement established MS therapies. Episode Highlights Exploring Environmental Risk Factors for MS Dr. Dalla Costa explains how her team investigates multiple environmental contributors to MS, including Epstein–Barr virus exposure, vitamin D levels, and now, ultra-processed food intake. Ultra-Processed Foods and Disease Activity Her findings show that MS patients with higher levels of ultra-processed food metabolites in their blood experience 30% more relapses and worse MRI lesion progression over five years. Metabolic Signatures and Biomarkers Dr. Dalla Costa outlines how measuring circulating metabolites in blood and urine offers an innovative way to assess dietary exposure objectively, bypassing unreliable food questionnaires. Dietary Classification and Health Impact The Nova system distinguishes between unprocessed, minimally processed, processed, and ultra-processed foods. Additives, preservatives, and colorants—while convenient—are linked to inflammation and metabolic stress. Towards Personalized Nutrition in MS Emerging evidence suggests that dietary modification could become a complementary approach in MS management. Dr. Dalla Costa envisions a future where AI and machine learning will personalize nutritional recommendations for patients. Future Directions in Research Her team plans to explore how ultra-processed foods affect the gut barrier, contribute to chronic inflammation, and potentially inform dietary policy and patient education globally. Key Takeaway Dr. Dalla Costa underscores that reducing ultra-processed food intake may serve as a simple yet powerful tool to support neurological health in MS patients. By combining validated therapies with mindful dietary choices, clinicians and patients can work together to mitigate inflammation and improve long-term outcomes. Resources Website: Newsletter: Connect with Dr. Gloria Dalla Costa: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/38855720

Biomarkers in Multiple Sclerosis: Tracking Disease Progression 12/23/2025

Biomarkers in Multiple Sclerosis: Tracking Disease Progression In this episode of MD Newsline, Dr. Ahmed Abdelhak, Assistant Professor of Neurology at the University of California, San Francisco, explores the cutting-edge world of fluid biomarkers in multiple sclerosis (MS). With over a decade of experience as an MS clinical scientist, Dr. Abdelhak shares his expertise on the evolving role of biomarkers in understanding, predicting, and managing MS progression. He breaks down how markers like neurofilament light chain (NFL), glial fibrillary acidic protein (GFAP), and chitinase (CHIT1/CHIT3) offer insights into the underlying neuroinflammatory and neurodegenerative processes in MS. From identifying axonal damage to detecting astrocyte activation and microglial involvement, these biomarkers are transforming how clinicians assess disease activity and progression risk. Dr. Abdelhak also discusses the potential of machine learning and AI-based models in interpreting complex, multi-center datasets — paving the way for personalized treatment strategies. He emphasizes the importance of cross-specialty collaboration, incorporating radiology, immunology, and physical therapy, to deliver holistic MS care that addresses both neurological and everyday challenges faced by patients. Episode Highlights Advancements in MS Biomarkers Dr. Abdelhak reviews emerging biomarkers — including GFAP and chitinases — and explains their cellular origins, from astrocytes to microglia, offering a multidimensional view of disease mechanisms. Clinical Value of GFAP and NFL He explains how GFAP reflects astrocyte activation and correlates with disease progression, while NFL indicates axonal damage. Combining both markers enables a more precise prediction of MS activity and long-term disability outcomes. Machine Learning and Data Integration AI is reshaping MS research by harmonizing large, noisy datasets and uncovering biologically meaningful clusters of patients. This integration of fluid, imaging, and genetic data supports early identification of disease subtypes and better treatment matching. Personalized and Holistic MS Management Dr. Abdelhak underscores the future of individualized biomarker trajectories, which could guide treatment adjustments and predict therapy response. He also highlights the need for patient advocacy, encouraging individuals to voice concerns about cognitive symptoms, fatigue, and depression often overlooked in clinical settings. The Path Ahead for MS Research He anticipates major breakthroughs in the next five years, especially in identifying new biomarker panels and understanding under-researched pathways involving astrocytes and microglia. Collaboration across specialties and clearer communication with patients will be crucial to translating these scientific insights into daily clinical care. Key Takeaway Dr. Ahmed Abdelhak emphasizes that fluid biomarkers are redefining MS care — enabling earlier, more accurate detection of disease progression and treatment response. The integration of AI tools, multi-omics data, and cross-specialty collaboration is driving a new era of precision medicine in neurology, offering patients more informed and individualized care pathways. Resources Website: Newsletter: Connect with Dr. Ahmed Abdelhak: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/38855650

Optic Neuritis, MS Differentials, and Modern Treatment Pathways 12/16/2025

Optic Neuritis, MS Differentials, and Modern Treatment Pathways In this episode of MD Newsline, Dr. Nilüfer Kale, Head of the Department of Neurology at Başakşehir Çam and Sakura City Hospital in Istanbul, Turkey, provides an in-depth look into optic neuritis, multiple sclerosis (MS), and related demyelinating disorders. She discusses the pathophysiology, diagnostic challenges, and treatment evolution of these conditions—offering valuable insights for clinicians managing autoimmune neuroinflammatory diseases. Dr. Kale also highlights the importance of accurate differential diagnosis, the role of neuroimaging and biomarkers, and how advancements in remyelination research are shaping the future of MS treatment. Episode Highlights Epidemiology and Patient Demographics Dr. Kale explains that autoimmune neurological disorders such as MS and optic neuritis predominantly affect young women in their childbearing years. She attributes this trend to the interplay of hormonal, genetic, and environmental factors, including vitamin D deficiency, Epstein–Barr virus exposure, and obesity. Pathophysiology of MS and Optic Neuritis She provides a detailed overview of how immune system activation, particularly involving T cells, B cells, and cytokines, leads to demyelination and subsequent neurodegeneration. While early disease stages may allow remyelination, progressive degeneration contributes to long-term disability. Diagnosis and Differential Considerations Dr. Kale emphasizes that early and accurate diagnosis is critical to preventing irreversible damage. Conditions such as neuromyelitis optica (NMO) and MOG antibody disease (MOGAD) can mimic MS, underscoring the need for MRI imaging, CSF analysis, and antibody testing to guide correct classification and treatment. Clinical Presentation and Early Detection Optic neuritis often presents with eye pain, color desaturation, and central vision loss. Dr. Kale notes that orbital and cranial MRI scans with contrast are essential for confirming inflammation and ruling out other causes such as ischemic optic neuropathy or ophthalmologic conditions. Treatment Strategies and Advances Standard management involves high-dose intravenous corticosteroids to accelerate visual recovery and delay MS onset, as shown in the Optic Neuritis Treatment Trial (ONTT). For severe or atypical cases, Dr. Kale recommends plasmapheresis or IV immunoglobulin (IVIG) therapy. She stresses tailoring therapy to the individual patient, noting that treatment protocols for MS, NMO, and MOGAD differ significantly. Evolving Therapies and Global Access Dr. Kale reflects on the progress from early interferon-based therapies to modern monoclonal antibody treatments, highlighting how health policy and access continue to affect patient outcomes worldwide. Emerging Research and Biomarkers Advances in PET imaging and astrocyte-targeted ligands show promise for identifying chronic lesions and smoldering plaques, which could pave the way for future remyelination-focused treatments. Patient-Centered Care and Gender Considerations Beyond science, Dr. Kale underscores the emotional and social burden faced by women living with MS—balancing family responsibilities, work, and health. She advocates for stronger patient networks and social support systems to improve quality of life. Key Takeaway Dr. Kale emphasizes that timely diagnosis, personalized therapy, and advances in neuroimaging and immunology are transforming MS and optic neuritis care. She calls for continued collaboration between clinicians, researchers, and policymakers to ensure equitable access to modern treatments and better long-term outcomes for patients. Resources Website: Newsletter: Connect with Dr. Nilüfer Kale: /episode/index/show/ecb5ed55-2779-489f-bef7-9484228289f1/id/38855590