Dr. Ramani Rheumatology

02/09/2026

RESET-RA explores a fascinating new direction in rheumatoid arthritis treatment — using the nervous system to influence inflammation.

Instead of targeting a cytokine or immune cell with another drug, a small implanted device stimulates the vagus nerve for just 1 minute each day, engaging neuroimmune pathways involved in inflammatory regulation.

In this randomized, double-blind, sham-controlled trial of 242 patients with moderately-to-severely active RA, active vagus nerve stimulation produced a significantly higher ACR20 response at 3 months than sham stimulation (35.2% vs 24.2%).

The effect is modest, but the concept is important: the nervous system itself may become a therapeutic target in immune-mediated inflammatory disease.

Could bioelectronic medicine eventually become another option alongside DMARDs, biologics and targeted therapies?

RESET-RA | Nature Medicine | 2026

Neuroimmunology AutoimmuneDisease Inflammation RheumatologyResearch DrRamaniRheumatology

19/08/2026

14/08/2026

The future of lupus treatment is changing — and there is more reason for hope than ever. 💜

For many years, lupus treatment relied heavily on hydroxychloroquine, steroids and immunosuppressive medications. These remain important, but treatment is becoming increasingly targeted and personalised.

We now have therapies such as belimumab, anifrolumab and obinutuzumab, with more treatments in clinical development.

For lupus nephritis, newer options are expanding our ability to protect kidney function while aiming to reduce long-term steroid exposure.

And perhaps one of the most exciting areas of research is CAR-T cell therapy — an approach being studied for its potential to deeply reset abnormal B-cell activity in severe, treatment-resistant autoimmune disease.

The goal is no longer simply to suppress inflammation.

✨ Better disease control
✨ Fewer flares
✨ Less steroid exposure
✨ More personalised treatment
✨ Better long-term outcomes

Science is advancing.
Options are growing.
And for people living with lupus, the future looks brighter than ever before.

You are not alone on this journey. 💜

Rheumatology AutoimmuneDisease CARTCellTherapy Rheumatologist DrRamaniRheumatology

14/08/2026

A patient recently asked me about CAR T-Cell Therapy for Lupus (SLE) 🧬 it’s very new and still being studied but remember it comes with its own complications. This is for refractory Sle not responding to the usual treatments .

CAR T-cell therapy is an exciting new treatment being studied for people with severe lupus that has not responded to standard treatments.

It works by using your own immune cells (T-cells). These cells are collected, modified in a laboratory, and then returned to your body to target and remove B-cells that contribute to lupus.

Think of it as a possible “reset” of the immune system. As new B-cells gradually return, the immune system may behave in a healthier way.

Early studies in selected patients with severe lupus have shown very promising remissions, with some patients able to stop their lupus medications.

⚠️ CAR T-cell therapy is still an emerging treatment for lupus. It requires specialist assessment and careful monitoring because serious side effects can occur.

A promising new direction in the treatment of severe lupus.

LupusAwareness Rheumatologist

13/08/2026

09/08/2026

Nepal — a spiritual land of breathtaking mountains, extraordinary people and a journey that left me with memories I will always treasure. 🇳🇵❤️

A few years ago, I had the privilege of joining a charity medical mission to Nepal.

We landed in Kathmandu and, the following morning, began a nine-hour journey into the mountains to Sindhupalchok — breathtaking views, winding roads and, at times, a rather back-breaking ride.

Life in the mountain villages was simple, but far from easy. The people worked incredibly hard, and access to healthcare was limited. At the medical camp, my role was to assess patients with joint problems and perform joint injections.

As the day went on, the sun disappeared behind the mountains. By around 4 pm, it was dark.

There was no electricity in the room where we were treating patients.

But there were still people waiting.

Some had walked for two hours from neighbouring villages for the opportunity to receive treatment. I simply didn’t have the heart to turn them away.

So Dawa, my interpreter, and I switched on the lights from our mobile phones — and carried on.

Under the light of our phones, I continued injecting joints until we had seen the patients who had travelled so far to reach us.

It was such a simple moment, but one I have never forgotten. It reminded me that medicine is not always practised in brightly lit consultation rooms with everything we need at our fingertips. Sometimes, you simply work with what you have — because someone has placed their trust in you.

The second part of our journey took us to the residence of the Kung Fu Nuns, about an hour from Kathmandu.

There, I had the pleasure of chatting with Jigme Yeshe. She was among the remarkable nuns who undertook a 4,000-km bicycle journey from Kathmandu, Nepal, to Leh, India, raising awareness about human trafficking and women’s rights.

Their courage, discipline and determination is inspiring. #

08/08/2026

What is your diagnosis ? Choose from the answers below
* Hip osteoarthritis.
* Lumbar radiculopathy.
* Iliotibial band syndrome.
* Meralgia paraesthetica.
* Sacroiliac joint dysfunction.
* Femoral neck stress fracture
* Greater trochanteric bursitis
Let me know your answer and will give you a link to the diagnosis.