Day 3 at the annual meeting was rich with information. Yet the most anticipated and best attended session was the Late Breaking Abstracts and the session revealing the new ACR/NPF Guidelines for Psoriatic Arthritis (more on the latter in another report). Day 4 was full of review sessions and a modicum of original content and for me, the 7:30AM Rheumatology Roundup.
Prof Weyland started by explaining that giant cell arteritis (GCA) and Takayasu Arteritis (TA) are granulomatous forms of arteritis. The age of onset is usually >60 years in GCA and < 40 years in TA, the group in the middle may be a different form of vasculitis based on gene expression studies.
The pathogenesis between microscopic gut inflammation leading to the development of Crohn’s disease and sacroiliitis has been poorly understood. Dr. Debusschere, et al sought to understand this important link between IBD and axial SpA. The group looked at the in situ expression of gut biopsy derived TNF, TNFR1 and TNFR2 from known SpA patients.
We know that cardiovascular disease (CVD) is the leading cause of death in RA and that traditional risk factors do not fully account for increased risk. It is also recognised that RA patients have fewer warning symptoms prior to major event and also have a higher case fatality rates for stroke and cardiac events.
In RA Clinical Aspects I Cardiac Co-Morbidities (abstracts 867-72) we heard data addressing risk stratification and mechanisms behind these observations.
From Dr. Michelle Petri’s lecture on Antiphospholipid Syndrome Updates at ACR17 Review Course on Saturday, I learned that there is now a new class of diseases called the complementopathies. This was the first time I heard of this term; how many patients did I misdiagnose who really had this and what are the ICD10 codes?!
Responding to criticisms that the 10 year maintenance of certification exam is expensive, time-consuming, and not reflective of clinical practice, the American Board of Internal Medicine recently issued changes to their requirements, allowing more options for physicians to recertify.