Spring 2021 (Volume 31, Number 1)

ACR Convergence 2020 Review

By Philip A. Baer, MDCM, FRCPC, FACR

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The American College of Rheumatology (ACR) pivoted their 2020 meeting wisely in the spring of 2020 to a fully virtual format, retitled ACR Convergence. By the time November rolled around, we were all veterans of virtual meetings, including platforms such as Zoom, GotoMeeting, MS Teams, Webex and others. I had “attended” EULAR 2020 in the first phase of the pandemic. Navigating posters was easy, but the platform had trouble coping with the large number of attendees for live sessions.

Given the absence of opportunities for real vacations, booking off my office from Thursday through Monday for ACR was akin to a busman’s holiday, but a break nevertheless. Registration and the introduction to the ACR Convergence platform went smoothly. As at all such meetings, you derive benefits proportional to the time invested. I spent time working through the agenda, finding interesting posters and plenary abstracts. It was easy to download relevant PDFs and PowerPoint slides, and to listen to short audio summaries of most posters. An interesting pearl for those still accessing the meeting resources, which are available online until mid-March 2021: In individual sessions under the FILE tab, no files may be listed, but the relevant PDF files can often be found by clicking on the individual speaker’s name and looking under their FILE tab.

Once the actual conference started, 16,000-plus attendees from 111 countries joined the platform. A triumph for ACR, but a massive loss for Washington D.C. hotels and restaurants, where the 2020 meeting was originally supposed to take place immediately after the U.S. elections. Most of us were thankful not to be there in the middle of a pandemic. Even with all those people online, I never crashed or failed to access the ACR meeting, but the video quality varied greatly. The feed froze at times, but the chat feature reassured me that I was not alone. The wisdom of ACR having pre-taped many of the lectures became evident, with the presenters available afterwards for live Q&A. Downloading slides in advance and following the lecture using those PDFs while listening to the speakers provided the best experience.

The opening session featured Dr. Eric Rubin, current New England Journal of Medicine (NEJM) editor-in-chief, providing an excellent COVID review covering drugs and potential vaccines. Many of these data had recently been published in NEJM. This was followed by a succinct Year in Review session with Drs. Yazdany and Bucala.

ACR awards included the Presidential Gold Medal conferred on
Dr. James O’Dell of RAIN and RACAT fame. This is the highest award that the ACR can bestow, awarded in recognition of outstanding achievements in rheumatology over an entire career. As well, one of our own, Ciarán Duffy, was recognized as a Master of the American College of Rheumatology.

The Great Debate featured Vibeke Strand, MD, on the pro side, and Michael Weinblatt, MD, on the con side of the proposition that “Janus Kinase Inhibitors Should/Should Not Be Used Before Biologics After Methotrexate Failure in RA.” Dr. Weinblatt was the clear winner in my view: 22 years of experience with anti-TNFs is a powerful plus, as well as the tapering possibilities for patients in LDA/remission, despite JAK inhibitors having advantages of oral administration, rapid efficacy, better monotherapy data, and some achievement of superior outcomes vs. anti-TNFs. The official poll favoured the con side by 2:1.

One benefit of the virtual format: No problem if you are interested in two sessions running simultaneously – you can switch back and forth or listen to one live and another later. No more rushing between lecture halls at opposite ends of a massive convention centre, though one also loses the benefits of that physical activity. Sitting for hours at the computer is more grueling and more detrimental to one’s physical health than many would have imagined in the pre-pandemic era. The usual drawbacks of online meetings were also evident: No one-on-one chats with poster presenters, no randomly stumbling upon an interesting poster while strolling the poster hall, and no serendipitous meetings with colleagues.

Another highlight for me was the superb Hench lecture by Dr. Gerd Burmeister on the history of biologic therapies in rheumatology. This was a great reminder of how far we have come in the last twenty years.

At live meetings, there is always a dichotomy between the official program of lectures, posters and symposia and the unofficial program of networking, sharing food and beverages with colleagues, and seeing the sights of the host city. Both provide value and enhance the total meeting experience. At virtual meetings, a similar parallel track exists. I would label this as ACR vs. “meta ACR.” The meta ACR featured the CRA’s concurrent program of daily updates, tweets, trivia challenges and game changers. Dr. Jack Cush ran a similar excellent RheumNow program, including two evening programs during the meeting with Dr. Artie Kavanaugh and a rotating crew of guest experts reviewing key highlights. More informal meta aspects included the chats and Q&A streams accompanying each session. Two colleagues and I maintained a group text chat throughout the meeting, keeping each other engaged and highlighting interesting sessions to attend.

Overall, ACR Convergence 2020 delivered a satisfying experience. The 2021 meeting is scheduled for November in San Francisco, but I expect a virtual component is here to stay.

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

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