What’s the Latest on RA from the Rheumatology World?
The American College of Rheumatology (ACR) is an organization for rheumatology healthcare professionals with a mission of education, research, advocacy and practice support.1 Your rheumatologist is probably a member of the ACR. The organization recently held their 2014 annual meeting in Boston. Over 10,000 people attend this conference and participate in a variety of sessions. There were special speakers, hundreds of presentations about clinical practice, medical education sessions, and presentations on the latest research findings. The exhibit hall, while representing many organizations, was physically dominated by the large pharmaceutical companies who produce and market the most widely used rheumatologic treatments. It’s important that patients suffering with rheumatoid arthritis know about recent events that may impact their healthcare. Below are brief highlights from the 2014 ACR conference.
Updated Diagnostic Guidelines
One of the biggest headlines coming out of the meeting was the announcement of new recommendations for updating diagnostic guidelines for RA. The ACR guidelines for diagnosing RA have changed dramatically over the past decade due to rapidly changing treatments and understanding about the disease. The new guidelines are patient centered and based on the latest research findings. I will write more about the new guidelines in a future article.
There were thousands of research presentations and abstracts are available in the October issue of ACR’s journal Arthritis & Rheumatology. Hot topics of research related to RA include the role of genetics, regulatory T lymphocyte cells, the immune system in the gut, periodontal disease, large data sets from hundreds of thousands of patients, cardiovascular complications, proteins involved in RA processes, biomarkers for diagnosing RA, and “triple therapy” of methotrexate/hydroxychloroquine/sulfasalazine.
These are generic type versions of biologics but are not exactly like the originals. They are being developed and approved in Asian and European countries and will eventually be approved in the United States. But large clinical trials will be required to determine their effectiveness and safety before approval.
In one session by called “Google Minefield”, a librarian recommended that rheumatologists not only acknowledge that patients search the Internet for information about their illnesses, but actively guide them in evaluating the quality of resources. This could be accomplished through providing evaluation checklists and even tablets with libraries of trusted websites in clinic waiting rooms.
Medical Cannabinoids for Chronic Pain
Cannabinoids are compounds found in marijuana that may provide chronic pain relief in rheumatology patients. Oral forms of cannabinoids, as opposed to smoking, are recommended to avoid the harmful effects on lungs and to reduce euphoria. Patients should discuss options with their rheumatologists. More research on dosing and physician education is needed in this area.
Projected Rheumatologist Shortage
The demand for rheumatology specialists will continue to grow and nurse practitioners (NPs) and physician assistants (PAs) will be called upon to meet the need. These mid level health care providers will need additional training.
Detailed summaries for each day of the conference can be found at http://www.acrannualmeeting.org/.
When was your last flare?