Vasculitis Expert Joins Division of Rheumatology and Clinical Immunology, Leads VascStrong Study Investigating Effects of Disease on Frailty and Quality of Life

In July, the Division of Rheumatology and Clinical Immunology welcomed Sebastian E. Sattui, MD, MS, as its new director of the UPMC Vasculitis Center. Dr. Sattui joined the Division as an assistant professor of medicine after completing his rheumatology and vasculitis fellowships at the Hospital for Special Surgery, Weill-Cornell Medicine in New York.

Dr. Sattui earned his medical degree from Cayetano Heredia University in Lima, Peru, followed by residency training at the University of Alabama at Birmingham. Dr. Sattui also earned a Master’s degree in clinical epidemiology and health services research from Weill-Cornell Graduate School of Medical Science.

As a rheumatology fellow, Dr. Sattui received the 2019 Vasculitis Clinical Research Consortium (VCRC)-Vasculitis Foundation (VF) Fellowship Award, which supports mentored training for physician/scientists with an interest in vasculitis to pursue advanced training in patient-oriented clinical investigation and clinical care of patients with these rare conditions. One of the studies that Dr. Sattui began conducting during this fellowship is the Vascular Strength Study, also known as VascStrong. This work continues. See below for a more detailed discussion of this important new study.

Clinical and Research Priorities

Dr. Sattui’s clinical and research efforts are focused on improving the care of patients living with vasculitis. His research so far has focused on the assessment of disease biomarkers and the treatment outcomes of patients living with the various types of vasculitis, including giant cell arteritis and ANCA-vasculitis, as well as polymyalgia rheumatica (PMR). Another prominent area of investigative interest centers on aging-related outcomes of patients living with vasculitis and PMR (as well as other inflammatory conditions), particularly how these disease processes and their treatments may contribute to the development of frailty, and how frailty in these patients compromises quality of life and clinical outcomes. 

Notably, during the last two years, and in response to the COVID-19 pandemic, Dr. Sattui became involved in different COVID-19-related research initiatives, including the COVID-19 Global Rheumatology Alliance. His work has focused on identifying the impact of COVID-19 on patients with rheumatic diseases, with a specific focus on disease outcomes in patients with vasculitis and PMR, and the use of immunomodulatory therapy to treat severe COVID-19. He has co-authored a number of studies on these topics to date (see below for references).

Investigating the Connection Between Vasculitis and Frailty: The VascStrong Study

Dr. Sattui serves as the principal investigator of the VascStrong study, supported by the Vasculitis Foundation, which he began conducting during his fellowship training. He continues to lead this investigation now that he has joined UPMC and the University of Pittsburgh.

The VascStrong study is examining how the various forms of vasculitis may impact the development of frailty and to what extent frailty exists as a morbidity in vasculitis. 

The prevalence of frailty in vasculitis patients is not well understood. It is an area of study that has garnered little prior investigation. The clinical complexities of the various forms of vasculitis and the varying degree of symptoms that patients experience lead to a complex interplay of how the disease process affects health-related quality of life and clinical outcomes.

The development of frailty can be a vicious cycle, one in which the patient progresses on a downward trajectory that can be difficult to alter. Understanding who is most at risk for frailty and what can help clinicians intervene early in a patient’s clinical course are paramount. New treatment modalities that can better support these aspects of health for patients with vasculitis are badly needed.

Dr. Sattui’s research will work to better understand how the impacts of vasculitis on overall health and frailty may be mitigated by preserving a patient's physical strength. The work also will allow Dr. Sattui to study potential risk factors for developing frailty as a consequence of vasculitis and how patients may be able to avoid some of the more debilitating morbidities. Ultimately this information may help inform the development of new treatment approaches or rehabilitative or prehabilitation models of care that can forestall or lessen the likelihood individuals may experience frailty due to this chronic and as yet incurable disease.

Dr. Sattui’s VascStrong study is currently recruiting patients and is open to adults with any form or diagnosis of vasculitis, including relapsing polychondritis. To participate in this study, patients need to be part of the Vasculitis Patient Powered Research Network (VPPRN). For more information about the VascStrong study and the VPPRN, visit this link: Vasculitis Strength Study (VascStrong).

Learn more about the UPMC Vasculitis Center and read a story about Dr. Sattui from the Vasculitis Foundation.

Further Reading

Sattui SE, Conway R, Putman MS, et al; Global Rheumatology Alliance. Outcomes of COVID-19 in patients with primary systemic vasculitis or polymyalgia rheumatica from the COVID-19 Global Rheumatology Alliance physician registry: a retrospective cohort study. Lancet Rheumatol. 2021 Nov 5. doi: 10.1016/S2665-9913(21)00316-7. Online ahead of print.

Sattui SE, Liew JW, Kennedy K, et al. Early experience of COVID-19 vaccination in adults with systemic rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance Vaccine Survey. RMD Open. 2021 Sep; 7(3): e001814.

Sattui SE, Crow MK, Navarro-Millán I. The role of immunomodulatory medications in the treatment of COVID-19. Opin Rheumatol. 2021 Sep 1; 33(5): 431-445.

Mackie SL, Brouwer E, Conway R, van der Geest KSM, Mehta P, Mollan SP, Neill L, Putman M, Robinson PC, Sattui SE. Clinical pathways for patients with giant cell arteritis during the COVID-19 pandemic: an international perspective. Lancet Rheumatol. 2021 Jan; 3(1): e71-e82. 

Sattui SE, Rajan M, Lieber SB, Lui G, Sterling M, Curtis JR, Mandl LA, Navarro-Millán I.
Association of cardiovascular disease and traditional cardiovascular risk factors with the incidence of dementia among patients with rheumatoid arthritis. Semin Arthritis Rheum. 2021 Feb; 51(1): 292-298.