Planning for Your Tomorrow, Today!
Planning the annual meeting is similar to aiming at a moving target because the future seems to be arriving faster than ever before. Given the challenges of planning this meeting, the ideas and session proposals submitted by ACR/ARHP members are essential to creating a successful and comprehensive annual meeting. The 2012 ACR/ARHP Annual Scientific Meeting promises to boast innovative sessions, ground breaking scientific abstracts, as well as hands-on skill training sessions, so mark your calendars today and make plans to attend – you are not going to want to miss the 2012 meeting!
Several planning committee leaders were asked why it was important for members to submit ideas and to predict what topics will be covered in DC. Here is what they said:
+ Myositis
- Myositis
Chester V. Oddis, MD, Chair of the ACR Annual Meeting Planning Committee, Professor of Medicine and Director, Rheumatology Fellowship Program, Arthritis Institute, University of Pittsburgh, Pittsburgh, PA notes, "the important thing in planning the meeting is to get balance, not only between clinical and basic science, but among all the subspecialties that fall under the rubric of rheumatology." Therefore, Dr. Oddis, "advise the members of the College, particularly clinicians, to stir up the planning committee with suggestions for discussion and in particular, to nominate individuals who are recognized as quality speakers and lecturers. The goal of the committee is to make the meeting attractive to everyone in the field." Dr. Oddis notes that, "perhaps the most important development in myositis has been the creation of the International Myositis Assessment and Clinical Studies Group. This brings organization to a specialty that lies within a subspecialty and allows a dedicated group of professionals to work more effectively toward developing consensus and standards on conducting and reporting studies of adult and juvenile myositis." He says the organization is facilitating research collaboration on the international level and designing trials of novel agents and new biomarkers, much of which may be presented at the ACR in 2012.
+ Osteoarthritis
- Osteoarthritis
"The ideas and suggestions College members offer are invaluable in helping the planning committee identify areas of broad interest to our rheumatology community. We evaluate each contribution," says planning committee member Richard Loeser, MD, Chief of the Section of Molecular Medicine at Wake Forest University, and Sub-Chair of the Planning Committee for the Basic Sciences. "Member suggestions are frequently combined to ensure an issue gets comprehensive representation on the program. We often touch base with members to expand on their ideas for presentations that will allow us to round out specific sessions. Members are much more likely to have their ideas considered when they are well prepared," he says.
"The near future will continue to bring improvements in imaging," says Dr. Loeser. "Imaging technologies have been advancing rapidly for several years and will continue to do so into the future. The standard up to today has been magnetic resonance imaging. For the past several years groups at Stanford University School of Medicine and elsewhere have been refining and advancing sodium magnetic resonance imaging, an imaging technology that promises a far more detailed look at soft tissues and may well allow risks to be assessed and osteoarthritis to be diagnosed in its earliest stages. The technology may initiate the development of new therapies and allow them to be evaluated in clinical trials."
Clinicians should anticipate new metrics for evaluating therapies and monitoring disease progress from the Osteoarthritis Initiative. "At the 2012 annual meeting we should see new analytical studies of imaging technologies and procedures derived from the large data set created by the Osteoarthritis Initiative, a multicenter, longitudinal, prospective observational study of knee osteoarthritis. One of the goals of this government-private industry sponsored study it to improve and sharpen diagnosis, provide new metrics for monitoring disease foster the development of new therapies," says Dr. Loeser. He adds that, "there will undoubtedly be studies of new biomarkers. This has been an area of great need and groups are working to identify biomarkers that will detect early disease and monitor disease progression. The combination of new biomarkers with advanced imaging is an area holding great promise."
+ Stem Cells
- Stem Cells
Anne-Marie Malfait, MD, PhD, Assistant Professor, Department of Biochemistry and Section of Rheumatology, Rush University Medical Center, Chicago, IL, notes that, "the members of the planning committee consider every suggestion, idea, and proposal that is submitted but as one might suspect those proposals well thoughtout and well organized get more discussion than some of the wellintended but sketchier ideas," which is why she urge those who are submitting suggestions and proposals to the committee for the benefit of the College to make the proposals brief but complete to ensure they get the attention they deserve. It is a good idea to identify the important aspects of a presentation and spell out its educational goals.
"Progress in the basic science has been slow and steady. There appears to be no foreseeable surprises on the horizon but then not everything is foreseeable," says Dr. Malfait. She said that, "in 2011 attendees might note that there is a strong focus on the origins of pain and pain management. Members should expect an increasing number of such studies in the future."
"There are also continuing advances in understanding the pathogenesis of the diseases and basic biologic and genetic mechanisms. These understandings will serve as the foundation for new treatments that may appear as soon as within the next two years. In recent years stem cell research and the potential role of stem cells in the therapy of rheumatic diseases has gotten deeper and broader. It would not be surprising if significant new therapies involving stem cells appear in the near future," says Dr. Malfait.
+ Pain Management and Technology in the Delivery of Care
- Pain Management and Technology in the Delivery of Care
Afton Hassett, PsyD, Associate Research Scientist, Department of Anesthesiology Chronic Pain & Fatigue Research Center University of Michigan Medical School, says that, "without the voices of members, the planning committee would have to rely completely on ideas being advanced by opinion leaders. While these are most certainly valuable, they do not necessarily comprise a comprehensive look at the issues. This is why contributions from younger members and those new to the field are essential to a successful meeting."
Dr. Hasset says, "the field of pain research is moving incredibly fast." There are ongoing trials of new pharmacologic agents and non-pharmacologic treatment strategies. "The most exciting and perhaps promising studies involve combinations of agents, physical and psychological exercises," she says.
"How we think about our patients has evolved substantially during the past decade and is continuing to evolve rapidly. Non-pharmacologic therapies include individualized exercise programs, physical therapy, cognitive behavioral therapy, meditation, yoga and other forms of communal exercise. There is a growing understanding of the role resilience factors such as positive affect and wellbeing can have on functional and neurobiological outcomes in patients with chronic pain," says Dr. Hasset.
She adds that, "technology is allowing us to bring therapy to patients much more efficiently and also to monitor their progress. Websites are providing information on therapies, exercise groups and organizations that offer support and news. These can be accessed from anywhere by anyone with a computer. The advent of third and fourth generation smartphones, computer tablets, notebooks and netbooks make information available anytime almost anywhere. It also allows specialists to monitor and direct patient progress."
+ Rehabilitation
- Rehabilitation
"Member contributions to the planning process are invaluable," says Linda S. Ehrlich-Jones, PhD, RN, CS, Clinical Research Scientist, Rehabilitation Institute of Chicago and the immediate past president of the Association of Rheumatology Health Professionals. "Without them, the meetings would not be able to achieve their breadth and scope, or examine many issues that might lie outside the respective specialties of planning committee members," she says.
Across the breadth of rehabilitative research, individuals and organizations are seeking to refine exercise regimens that will benefit patients and equally as important, identify motivational tools that will keep patients engaged in beneficial exercise. "It is not often difficult to convince a patient to engage in exercise when the disease is first diagnosed but as with any chronic, progressive disorder, maintaining that interest can be exceedingly challenging as time passes," says Dr. Ehrlich-Jones.
"The need for refined exercise programs and motivational tools that will not only engage patients but keep them engaged is becoming increasingly important in the face of the growing epidemic of obesity in the US," she adds observing that, "obesity not only exacerbates symptoms but is indicative of a patient's reluctance to pursue a healthy exercise regimen. This is one of the many factors driving research in therapeutic and rehabilitative exercise. Members of the College can expect a continuing flow of reports and studies in this field well into the future."
+ Systemic Lupus Erythematosus
- Systemic Lupus Erythematosus
"Members of the College should know that the planning committee really wants to hear from them and that we pay attention to everything we receive from one to two-line suggestions to comprehensive proposals for symposia," says Mary Cronin, MD, Professor, Medical College of Wisconsin, Division of Rheumatology in the Department of Medicine, and Sub-Chair of the Planning Committee for Clinical Science. "The committee is continually striving for balance across the spectrum of issues. We pay attention to what has been emphasized in previous years and what members want for coming meetings. No idea is too small and no idea escapes notice," she explains.
"I've focused my interests on lupus and the myopathies, and it is an exciting time in both fields. Lupus research appeared to be resting on a plateau for a number of years. Our choice of therapeutic agents has been very limited. The recent approval of belimumab, a monoclonal antibody, has pushed a number of new and novel agents into the development pipeline. Our options are expanding rapidly and will continue to do so into the foreseeable future."
Dr. Cronin also notes that, "pathophysiology research is providing insights into lupus and new biomarkers are being identified. She expects some of these biomarkers will have a therapeutic role and will not be limited to monitoring clinical trials. "There is a continually growing flow of new information about the statin-related inflammatory myopathies. Newly identified auto-antibodies are being studied that may allow us to define a subset of patients who will benefit from immunosuppression even though their muscle biopsies may show no signs of inflammation," says Dr. Cronin.
+ Juvenile Idiopathic Arthritis
- Juvenile Idiopathic Arthritis
Peter A Nigrovic, MD, Assistant in Medicine, Director, Center for Adults with Pediatric Rheumatic Illness, Children's Hospital of Boston, advises that, "members of the College and attendees should get to know the members of the planning committee. Ideas and suggestions can be readily transmitted casually. Full proposals should be complete, although the planning committee does a good job in general of identifying and meeting the needs of the community, I think too few members take advantage of the opportunity to contribute to the annual meeting."
"The Childhood Arthritis and Rheumatology Research Alliance will celebrate its 10th anniversary this year. The organization has been infused with a new energy after receiving two large National Institutes of Health Grants," says Dr. Nigrovic. One of these grants is being used to develop the CARRA-Net, a disease registry that will identify data points and support data entry ports at 60 nationwide CARRA clinics. "It is anticipated that the organization and its new data bank will help shape a variety of studies." Dr. Nigrovic says that, "relatively rare disorders make it expensive and difficult to acquire subjects for trials. The CARRA infrastructure will permit the development of a range of observational trials that will draw data from centers around the nation. The organization will permit the creation of cohorts large enough for study findings to achieve significance. Patients can be randomized, not by a registry in a single clinic or region, but by computer that will span the nation. This should allow the creating of some valuable observational trials."
He also called attention to another grant awarded to Carol Wallace, MD, of the University of Washington School of Medicine and Seattle Children's Hospital. "Dr. Wallace will be developing effectiveness research in the four primary pediatric rheumatic diseases: arthritis, dermatomyositis, lupus and localized scleroderma. I see big things coming from this and related work in 2012," says Dr. Nigrovic.
+ Antibodies
- Antibodies
Diane Kamen, MD, MS, Assistant Professor of Medicine, Division of Rheumatology and Immunology, Medical University of South Carolina concurs with Dr. Loeser that "the planning committee often gets a number of proposals and suggestions focused on the same subject or concept. These multiple contributions help the committee assess member interest in subjects and touch on subtle aspects of an issue that might have otherwise been overlooked. The contributions also help us identify talented speakers and educators who are highly respected in their fields at local levels but who might otherwise escape attention at the national level."
"There is a great deal of research energy going into detecting and screening for antibodies that may allow a diagnosis even before clinical symptoms become manifest. The tests and assays that evolve from this research might well allow the assessment of risk of progression to rheumatoid arthritis or scleroderma," says Dr. Kamen. In addition, she notes that "belimumab was approved by the FDA for patients with active, autoantibody-positive lupus. The IV administered agent targets B-lymphocyte protein and has the potential of opening doors to newer therapies and of revolutionizing clinical trials of biologic therapies."
Dr. Kamen added that, "we are also getting data from large prospective studies of people with pre-clinical antibodies. These will help identify some of the more likely environmental and epigenetic triggers of the disease and take appropriate preventive action. I expect that soon there will be a lot to discuss in this arena."
