UPMC Rheumatology Division Faculty Spotlight: Myositis Specialist Didem Saygin, MD

Clinician-scientist Didem Saygin, MD, is an assistant professor of Medicine in the Division of Rheumatology and Clinical Immunology at UPMC and the University of Pittsburgh School of Medicine. She joined the Division in July 2022 to continue her research program and clinical care of patients with rheumatologic disorders, specifically myositis, in the division’s Myositis Center of Excellence, one of the oldest and largest dedicated myositis centers in the United States.

Dr. Saygin earned her medical degree at Istanbul University in Turkey. Her clinical studies during medical school focused on Behcet’s syndrome, how the disease affects patients' fertility and behavioral health, such as depression and suicide. After medical school, Dr. Saygin entered a postdoctoral fellowship program at the Cleveland Clinic Lerner Research Institute and The Center for Vasculitis Care and Research, where she performed studies in pulmonary hypertension and vasculitis, and gained further experience in the design and conduct of clinical research studies and trials.

“In medical school, I developed an interest in rheumatology as a specialty," says Dr. Saygin. "Most rheumatologic diseases are rare and fascinating disorders to study scientifically. There also is a serious and growing shortage of clinical rheumatologists in the U.S., so helping to fill this need with my career is fulfilling. We have a lot to learn in rheumatology; we still do not know what causes these diseases, and we have limited treatment options available. There’s a lot of opportunity to make significant advances to improve our patients’ health.”

Dr. Saygin completed her internal medicine residency at the University of Pittsburgh and a rheumatology fellowship at the University of Chicago before returning to Pittsburgh to join the division as a faculty member. Of note, Dr. Saygin was awarded the prestigious Distinguished Fellow Award from the American College of Rheumatology in 2022 for her academic work, clinical care, and community service. The award is presented up to only 10 fellows each year.

"There were several reasons I came back to Pittsburgh to continue my research and clinical work," explains Dr. Saygin. "UPMC is one of the premier centers in the U.S. for rheumatology, with its multiple centers of excellence focused on specific diseases and several multidisciplinary clinics. This visionary academic structure facilitates both research and clinical care. On the clinical side, we have a robust triage system called the Rapid Access Video Encounter Program (RAVE), where new patients can be seen quickly by a specialist through a telemedicine visit and then referred appropriately for follow-up care, either in the division or elsewhere in the system. The division also has a strong infrastructure for basic science and clinical/translational research. There are many NIH-funded investigators and ongoing clinical trials that our patients can participate in, so I wanted to be part of this amazing and collegial organization.”

Clinical Areas of Emphasis

For the last five years, Dr. Saygin’s clinical focus has been on inflammatory myopathies – i.e., myositis. UPMC has one of the few myositis centers in the country, and she currently has a dedicated clinic each week in the center, along with a weekly general rheumatology clinic where she sees patients with other rheumatologic disorders.

“I see new patients with suspected myositis and work to follow our established patient population,” says Dr. Saygin. “In addition to the multidisciplinary nature of our clinic, we have numerous opportunities for our patients to participate in clinical research studies, with several open clinical trials for our patients who are refractory to conventional myositis therapies.”

Dr. Saygin also has a growing interest in the clinical application and research around musculoskeletal ultrasound for patients with rheumatologic diseases.

Research Focus and Priorities

As a clinician-scientist, the majority of Dr. Saygin’s time is devoted to research, the focus of which is myositis.

She has several longstanding interests with multiple active investigations.

Outcomes Measures and Objective Patient Assessments

One primary area of interest is in studying and improving the use of clinical outcome measures designed to assess and monitor the patient's clinical status and response to therapy.

“As myositis is a disease that primarily affects proximal skeletal muscles, causing inflammation and degeneration leading to weakness, the vast majority of the patients develop functional limitations over time,” says Dr. Saygin.

As she explains, while helpful, the current patient assessment tools and outcomes measures that are routinely used suffer from several limitations, particularly concerning subjectivity.

“We need more robust objective tools to accurately assess our patient's condition longitudinally,” notes Dr. Saygin. “My work in this area is focused on developing and validating objective measures to evaluate and monitor clinical status. For example, I have been working with a hand-held dynamometry device that can be used to measure muscle strength, rather than the traditional approach, which is a doctor using their own hands to evaluate and categorize a patient’s strength. This work is one of the first studies done with this device in myositis.”

Similarly, Dr. Saygin explains her work which also entails measuring patients' physical activity levels through wearable physical activity monitors, like the Actigraph^® and Fitbit^® devices, that can provide more objective measures of a patient's activity level. She and her colleague's preliminary work has shown that these devices hold great promise for monitoring patients over long periods.

Better Use and Understanding of Patient Perspectives

Another research interest of Dr. Saygin is how rheumatologists can better incorporate patient perspectives into clinical study design and provide more patient-centric clinical care.

“One of the most notable studies we have published recently on this subject is where we worked with OMERACT,” says Dr. Saygin. “OMERACT brings together all the stakeholders including patient research partners, and nonphysician health care professionals to work on these questions.”

A critical aspect of this work to emerge is a clearer understanding of symptoms patients are experiencing that are the most important to them, their health, and their overall quality of life.

Through this work, Dr. Saygin and colleagues have conducted focus groups and identified symptoms that matter most to patients with myositis, which have emerged to be fatigue, pain, and physical function.

“This understanding is important because it has clinical implications for physicians treating patients with myositis – how they assess patient’s health and function, and also in how we conduct some of our clinical studies and research,” says Dr. Saygin.

She and her colleagues also have recently validated tools to be able to measure these symptoms in clinical practice and trials.  

Ongoing Service in the Rheumatology Field

The field of rheumatology is one of the smaller medical subspecialties, and many of the providers and researchers in the field are actively involved in ongoing support and educational work to advance various aspects of the discipline. Dr. Saygin has several ongoing areas of work in this field. She is currently a member of the American College of Rheumatology (ACR) and International Myositis Assessment and Clinical Studies (IMACS) Group, and she is the current chair of the American College of Rheumatology Fellows in Training Subcommittee.

“There is an anticipated worsening in the shortage of rheumatologists in the U.S.,” says Dr. Saygin. “One of my volunteer priorities with the ACR is to help support rheumatology fellows’ needs and work on sustaining our future clinical workforce.”

Dr. Saygin also is the current vice chair of the Data Sharing Group and member of the IMACS Meeting Committee.

Recent Scientific Contribution Highlights

Below is a selection of Dr. Saygin’s recent published research and links to further reading for some of the topics discussed in this article.

• DiRenzo D, Saygin D, de Groot I, et al. Reliability and Validity of PROMIS Physical Function, Pain Interference, and Fatigue as Patient Reported Outcome Measures in Adult Idiopathic Inflammatory Myopathies: International Study From the OMERACT Myositis Working Group. Semin Arthritis Rheum. 2023; 58: I52111. Online ahead of print.
• Saygin D, Oddis CV, Dzanko S, Koontz D, Moghadam-Kia S, Ardalan K, Coles TM, Aggarwal R. Utility of Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Form in Inflammatory Myopathy. Semin Arthritis Rheum. 2021; 51(3): 539-546.
• Saygin D, Oddis CV, Moghadam-Kia S, Rockette-Wagner B, Neiman N, Koontz D, Aggarwal R. Hand-Held Dynamometry for Assessment of Muscle Strength in Patients With Inflammatory Myopathies. Rheumatology. 2021; 60(5): 2146-2156.
• Saygin D, Rockette-Wagner B, Oddis C, Neiman N, Koontz D, Moghadam-Kia S, Aggarwal R. Consumer-Based Activity Trackers in Evaluation of Physical Activity in Myositis Patients. Rheumatology. 2021; 0: 1-6.

Learn more about Dr. Saygin and the Myositis Center at UPMC.