A Century of Caring for Patients With Rheumatologic Conditions

By Abby Abelson, MD

At the forefront of rheumatology

Cleveland Clinic was at the forefront of modern medicine when its founders organized it as a multi-specialty group practice in 1921. This forward-thinking, innovative spirit lives on today. In its first 100 years, Cleveland Clinic has introduced many medical firsts, opened facilities around the world and is proud to be ranked among the top hospitals in the country.

Cleveland Clinic innovations in rheumatology

Rheumatologists have been innovating at Cleveland Clinic for more than 50 years, from the use of methotrexate in RA, to the treatment of HIV and multicenter trials. Landmark Cleveland Clinic innovations in rheumatology include:

• As early as 1963, Arthur Scherbel, MD discovered that methotrexate prevented joint damage caused by rheumatoid arthritis (RA), nearly 20 years before the drug came into common use and paved the way for more specific anti-inflammatory agents in use today. Methotrexate, a chemotherapeutic agent primarily used to treat certain malignancies, was the first drug shown to prevent the joint damage caused by RA. Better control of severe RA has more recently been achieved with more specific anti-inflammatory agents directed at inflammatory cytokines, such as TNF-alpha, more safely and effectively. Other (older) treatments for RA included colloidal gold and d-penicillamine, which were not very effective in addition to being unacceptably toxic, and are no longer in use.
• In the 1970s, John Clough, MD, created a laboratory dedicated to immunopathologic services pioneering the use of clinical assays for complement, immune complexes and beyond. He also began assessing patients with primary immunodeficiency states and treating patients with immunoglobulin replacement.
• In the 1980s, Leonard Calabrese, MD, was the first rheumatologist in the country to engage in HIV care and research. In the last decade, Dr. Calabrese pioneered the first combined rheumatology infectious disease training program in the country.
• In the 1990s, Gary Hoffman, MD, founded the Center for Vasculitis Care and Research at Cleveland Clinic and conducted the first multicenter trials in giant cell arteritis as well as the first randomized trials of a biologic agent in vasculitis. The Center currently has eight faculty members who continue to expand its tripartite missions in patient care, research and education.
• In 2004, Carol Langford, MD, MHS, led the first randomized trial in Takayasu’s arteritis and formally established the fellowship in vasculitis at Cleveland Clinic.
• In 2006, Chad Deal, MD, promoted the treatment of hypophosphatasia — a congenital metabolic condition that causes frequent bone fractures and tooth loss — with teriparatide. Teriparatide reverses the bone demineralization caused by the disease.

About the author

Abby Abelson, MD, is Chair of Cleveland Clinic’s Department of Rheumatology, Vice Chairman for Education at the Orthopaedic & Rheumatologic Institute, and Education Program Director in the Department of Rheumatologic and Immunologic Diseases, as well as Director of Education at the Center for Osteoporosis and Metabolic Bone Disease. In 2020, Dr. Abelson was designated as a Master of the American College of Rheumatology (ACR).

Dr. Abelson earned her medical degree from Case Western Reserve University School of Medicine and completed her internship and residency in Medicine at Mt. Sinai Hospital in Cleveland, where she was Chief Resident. She subsequently completed a fellowship in Rheumatology at University Hospitals of Cleveland.