Spring 2022 (Volume 32, Number 1)
Highlights from ACR Convergence 2021
By Philip A. Baer, MDCM, FRCPC, FACR
Download PDF
This information is brought to you by the Journal of the Canadian
Rheumatology Association and is not sponsored by, nor a part of,
the American College of Rheumatology.
I did not leave my heart in San Francisco, where the
American College of Rheumatolgy (ACR) 2021 was originally
scheduled to occur, as the pandemic forced a
pivot for a second year to the all-virtual format known as
ACR Convergence. Programming was extended from November
1st-10th, including a Global Rheumatology Summit,
Basic and Clinical Research Conference and the ACR
Review Course, as well as a jam-packed meeting. From mid-December to mid-February, there will also be post-conference
weekly sessions on Fridays with poster tours and debriefs
highlighting the more common rheumatic diseases.
The platform was robust, including pre-recorded lectures
on VIMEO with live Q&A sessions thereafter. Study
Groups and Community Hubs on every conceivable rheumatology
topic were sprinkled through the conference.
Community Hubs included Meet-the-Expert sessions, as
well as abstract presenter lightning rounds and difficult
case discussions. Multiple streams catered to areas such as
pediatric rheumatology, the business of rheumatology, interprofessional
care and early career issues. It was possible
to attend from 7:30 am to 7:00 pm every day, though not
recommended either physically or mentally.
Almost every poster and abstract presentation could be
downloaded in PDF format, and short audio synopses of the
posters were virtually universal. The ORAL-Surveillance
study was featured in at least four presentations (0831,
1684, 1940, 1941) and the FDA Update session, though
the full study remains unpublished. Late breaker posters
focused of course on COVID-19, as well as cardiovascular
issues with hydroxychloroquine, gout, and new therapies
such as avacopan for antineutrophil cytoplasmic antibodies
(ANCA) vasculitis, pirfenidone for rheumatoid
arthritis-associated interstitial lung disease (RA-ILD) and
sequential biologics for systemic lupus erythematosus
(SLE) (BLISS BELIEVE study). A positive phase 2 trial of secukinumab
in giant cell arteritis (GCA) (LB19) also caught
my interest. Other key studies with interesting acronyms
were presented, including VITAL, KEEPSAKE, STOP-JIA,
and GLORIA. Social media and interactivity were prominent,
with #ACR21 Tweet Ups, polls, and lots of activity
in the chat and Q&A functions of most presentations.
There were 2,500 speakers and presenters involved,
which may be a new record. More than 2,000 abstracts
were presented. Official attendance was 14,000 people
from 110 countries. Canadians were prominent as usual,
many moderating key sessions, as well as presenting original
research based on Canadian cohorts and registries. I
attended the adult Thieves Market session (9T115), where
two of the four presenters were Canadian rheumatology
fellows: Jehanya Jegatheeswaran from Queen’s (A Bone to
Pick) and Maria Powell from the University of Calgary (The
Disease that Cried Wolf). All the cases were fascinating,
with a key take-home message that infectious diseases can
masquerade as rheumatic conditions (SLE is not the only
disease with protean manifestations). As the winning presenter
noted, “TB can cause anything except pregnancy”.
We were also well-represented in the ACR and Association
of Rheumatology Professionals (ARP) awards, which
included ACR Masters John Hanly (also a plenary session
presenter on functional connectivity in neuro-SLE) and
Rayfel Schneider, ACR Distinguished Clinical Investigator
awardee Brian Feldman, and ARP award winners Debbie
Feldman (Addie Thomas Service Award), Catherine Backman
(Lifetime Achievement Award) and Monique Gignac
(Ann Kunkel Award). Many of them are individually featured
in this issue’s Awards and Accolades section.
Issues around equity, diversity and inclusion were prominently
featured, as they will be at the upcoming CRA
ASM 2022 as well. The ACR Rheumatology Image Bank
solicited new slides featuring cutaneous manifestations of
diseases in patients with various skin colours, for example.
The opening keynote speaker, Dr. Seema Yasmin, spoke
informally as part of a conversation with ACR President
Dr. David Karp. Dr. Yasmin is both a physician epidemiologist
and a journalist, having trained at the Dalla Lana
school at the University of Toronto, and now based at
Stanford. She spoke on vaccines and medical myths,
amongst other topics. I plan to read her latest book, “Viral
BS: Medical Myths and Why We Fall for Them,” when I have
the opportunity.
The Great Debate featured Dr. Michelle Petri and
Dr. Brad Kovin debating the merits of belimumab versus
voclosporin, the latter developed by a Canadian company,
for the treatment of lupus nephritis. Dr. Petri was the winner
with 70% of the votes.
There were excellent named lectureships, including the
Gluck lecture on “The Role of Bone in OA” by Dr. Marc
Hochberg, the Arend lecture by
Dr. Gary Firestein on “The
Disease Formerly Known as RA,” the Klemperer lecture
by Dr. Peter Gregersen on “Forty Years of Working on a
Changing Research Landscape from RA to Endometriosis”,
and the Dubois lecture by Dr. Aimee Hersh on “Defining
Research Priorities in Pediatric Lupus”. Who knew that tumour
necrosis factors (TNFs), IL-1 and IL-6 were involved
in the pathogenesis of endometriosis? That was only one of
the fascinating facts I picked up.
The Year in Review was traditional in format, with basic
science and clinical segments. The Closing Session was
different, with a moderator and four discussants chatting
without slides. The participants highlighted new information
presented on polymyalgia rheumatica (PMR)/giant
cell arteritis (GCA), multisystem inflammatory syndrome
in children (MIS-C) related to COVID-19 infection in
pediatric patients, rehabilitation and employment in the
rheumatic diseases, environment-genetic interactions
affecting disease pathogenesis, the microbiome, dietary
supplements such as fish oil, Vitamin D, and omega-3s,
geriatric rheumatology, and the impact of climate change
and pollution on autoimmunity.
Other highlights: The ACR Knowledge Bowl, the ACR’s
counterpart to RheumJeopardy, was won by the Gulls of Galveston,
based in Texas. More information was presented
from the Accelerating Medicines Partnership (AMP) which
is working to develop novel therapies in rheumatology.
Dr. Kenneth Saag was formally installed as the 85th ACR
President.
The plan is for ACR 2022 to be live in Philadelphia, but
a hybrid meeting with a virtual component remains quite
likely.
Philip A. Baer, MDCM, FRCPC, FACR
Editor-in-chief, CRAJ
Scarborough, Ontario
|
