CRAJ Winter 2017

Winter 2017 (Volume 27, Number 4)

ACR 2017 in San Diego

By Philip A. Baer, MDCM, FRCPC, FACR

San Diego is a favoured venue for ACR’s Annual Scientific Meeting. This year marked the 3rd time since 2005 we returned to the San Diego Convention Centre sandwiched between the historic Gaslamp quarter and the Pacific. Nostalgia buffs can relive the 2013 meeting at www.craj.ca/archives/2014/English/Spring/Baer.html.

The news leading up to the meeting was not the most auspicious. Dr. Jack Cush’s RheumNow blog highlighted an intractable local outbreak of Hepatitis A (rheumnow.com/content/hepatitis-outbreak-san-diego).

Two weeks before the meeting, local temperatures were an uncomfortable 38-40 °C. Fortunately, they moderated by the time we arrived.

Finally, eight prototypes for the famous Trump US-Mexico border wall were unveiled near the Otay Mesa border crossing in San Diego (www.cnbc.com/2017/10/24/prototypes-for-us-mexico-border-wall-unveiled.html).

There were also rumours of lower ACR attendance figures given an atmosphere of travel bans, and fears of issues getting into and out of the US for some attendees. These proved not to be factual, as the 2017 meeting statistics showed: Over 3,000 accepted abstracts, 16,000 attendees with 12,000 scientific attendees, hailing from 110 countries.

The actual meeting was the usual three-ring circus requiring navigation through thousands of posters, hundreds of oral presentations, and many state-of-the-art lectures. The Great Debate on biosimilars was very topical. Roy Fleischmann faced off against Jonathan Kay, a highly published authority on the field. Much of the debate centred on the peculiar American drug pricing regime, which helped to explain the low penetrance of biosimilars in the US to date.

New draft ACR guidelines on psoriatic arthritis were helmed by one of our own, Dr. Dafna Gladman. These guidelines were the first to recommend a biologic (TNF inhibitor) over conventional DMARDs (retitled OSMs for oral small molecules to include apremilast) in treatment-naïve patients with active psoriatic arthritis. We had a spirited discussion at the ensuing press conference as to the practicality of implementing this particular recommendation in the Canadian health-care context.

Dr. Murray Urowitz received an ACR Distinguished Clinical Investigator award. Dr. Johanne Martel-Pelletier of Montreal osteoarthritis (OA) fame was designated an ACR Master, as was an ex-Montrealer, Dr. Robert Terkeltaub, whom I recall training with in Internal Medicine before he became a world expert in gout. Another ex-Montrealer, Dr. Simon Helfgott, won the ACR Distinguished Fellowship Program Director Award. Dr. Elizabeth Badley won the ARHP Distinguished Scholar Award.

The 2017 ACR meeting took place in San Diego's historic Gaslamp Quarter.

Both the CRA and CRAJ Boards met during the meeting. Canada Night at the San Diego Central Library was very well-attended.

Staying relatively far away from the Convention Centre kept me on-site and focused on the meeting. I had participated in authoring only one poster (efficacy of tofacitinib on pain, Abstract #614), but I was not the presenting author. I had hoped to meet up with one of my famous co-authors, Dr. Iain McInnes, but he was otherwise occupied apparently.

I was particularly pleased with the three free Poster Tours I signed up for. We had excellent leaders, including Drs. Jonathan Kay, Alexis Ogdie and Paul Emery. The tours focus on abstracts rated highly by the abstract selection committee, often featuring globally famous rheumatologists. We met up with Maxime Dougados, Ed Keystone and Artie Kavanaugh among others.

ACR press conferences featured abstracts highlighting the negative impact of obesity on RA, SpA and SLE (Abstracts # 1898, 2263, 2372, and 2508), pitfalls in MRI imaging of the SI joints (frequently positive in healthy people and frequent runners, Abstract #1831), and issues around opioid use in rheumatology (Abstracts # 2235 and 2783). The ACR Annual Meeting app and the ACR2017 Twitter feed were very useful in navigating the meeting. Themes I focused on included benefits of subcutaneous.(s.c.) vs oral MTX (no surprise to Carter Thorne, but apparently news to many US rheumatologists), benefits of HCQ on TNFi drug survival, and the hot topic of possible thromboembolic phenomena in studies of JAK inhibitors.

Overall, it was another excellent meeting, featuring great food, interesting science and valuable networking opportunities. A direct flight to and from Toronto was a bonus. Of course, as soon as I returned home, the meeting cycle spun another quarter turn and it was time to register for CRA and book flights and hotels for Vancouver. See you there and at ACR 2018 in Chicago next October.

Philip A. Baer, MDCM, FRCPC, FACR
Editor-in-chief, CRAJ
Scarborough, Ontario