Rheumatology research at Mayo Clinic includes basic science and clinical research. The common goal of the basic science and clinical research programs is to find new ways to care for patients and advance understanding of rheumatic diseases. Focus areas include:
The Division of Rheumatology has a long tradition in epidemiologic research. Numerous publications have reported the frequency of rheumatic diseases in the community, along with disease outcomes and trends. The division carries out multiple studies among residents of Southeast Minnesota, Mayo Clinic patients and other populations.
Pharmacogenomics and individualized medicine
Currently, no individualized prediction tool for treatment of rheumatic diseases is available. In collaboration with the Center for Individualized Medicine and Mayo Clinic Biobank, the division is using machine-learning methods to develop algorithms to inform anti-rheumatic medication selection for patients with rheumatoid arthritis. Medications are tailored to individual patients based on their genomic, clinical and sociodemographic data. This approach is expected to provide timely information about effective treatment options for patients with rheumatoid arthritis. At the start of treatment, the right medication may be tailored for the right patient at the right time.
For many clinical decisions confronting patients with rheumatic diseases and their health care providers, evidence is inadequate for fully comprehending the potential benefits and harms of a medical intervention. In these situations, use of shared decision-making is recommended. But the best practices for shared decision-making are unclear. The division is studying the impact of integrating patient-reported outcome measures among patients with rheumatoid arthritis. Between visits, data is collected using a mobile health application regarding patient experiences with shared decision-making and control of disease activity. The results are expected to inform the development of new interventions in clinical practice to enhance shared decision-making with patients about treatment options.
Vasculitis refers to a family of about 20 rare autoimmune diseases characterized by damage to blood vessels, which can result in tissue ischemia and failure of vital organ systems. The need is urgent to improve our scientific understanding of these diseases, and the way they progress, to establish more accurate diagnoses, more effective treatments and, ultimately, to discover a cure.
As a center of excellence in the care of patients with vasculitis, Mayo Clinic is uniquely qualified to lead this effort through the collaboration between the Division of Rheumatology and the Gonda Vascular Center. The division is actively recruiting these patients to participate in research studies and to build the most diverse biorepository of patient samples and data in the world. The information the patients provide can deepen our understanding of these complex diseases.
Mayo Clinic's expert investigators in the field of vasculitis have identified unmet needs that require ongoing research to make significant progress in the treatment of these diseases. One condition under scrutiny is giant cell arteritis (GCA). Mayo Clinic has a long-standing tradition of research in this area, as the first biopsy to prove the diagnosis of GCA was performed at Mayo Clinic in 1932. Patients with GCA at Mayo were the first to be treated with cortisone in the 1940s, which was able to prevent blindness in many individuals. GCA also can cause other devastating consequences such as stroke and aortic aneurysms.
The division's research in GCA and other forms of vasculitis includes ongoing clinical and translational research efforts, as well as collaborations with colleagues across other major institutions in the U.S. and abroad.
In the long term, the path to more successful treatment — and a possible cure — for vasculitis must include a deeper understanding of the molecular characteristics of these diseases. Mayo Clinic's researchers seek to uncover the root cause of blood vessel inflammation, which would improve our understanding of vasculitis. But it also would advance an entire field of cardiovascular research, potentially contributing to a better understanding of more-common blood vessel conditions such as heart disease and stroke. In addition, the division endeavors to improve the standard of care and quality of life for people affected by vasculitis and other autoimmune diseases.