Last November, I had the opportunity to travel to Washington, D.C., to participate in the Annual Meeting of the American College of Rheumatology (ACR). This prestigious event brings together rheumatology experts from around the world to exchange the latest ideas on cutting-edge research and clinical practice.
This year, the conference did not offer live streaming. With the decline of COVID, virtual attendance had decreased, while in-person participation had grown significantly, demonstrating a strong desire for face-to-face engagement.
By attending in person, I was able to reconnect with my American and European colleagues, particularly those specialising in my favourite topics: polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). The EULAR/ACR study group on PMR and GCA—of which I have been a member for more than 10 years—held an excellent workshop to discuss new research, both in the laboratory and in clinical practice. I also had the opportunity to discuss my English language monograph on PMR, edited by Professor EL.
Matteson, Mayo Clinic, published by NOVA Science Co, New York. Some outstanding posters were on display, emphasising the role of imaging in detecting subclinical vasculitis in chronic PMR. The study of geriatric syndromes has become an increasingly important aspect of PMR research. It is crucial to recognise that PMR is the most common inflammatory disease in older adults—an age-related musculoskeletal condition that is expected to double in prevalence in the near future.
The pre-congress review course has always been my favourite part of the meeting, and this year, it attracted the highest level of interest. The widely used “Treat-to-target" strategy has already been realized in RA treatment. Instead, the concept of “Difficult-to-treat RA" has become a new updated paraphrase, which has to be solved in the near future. This term refers to patients who have failed treatment with at least two biologic or targeted synthetic DMARDs, making further management particularly challenging. Co-morbidities, polypharmacy, psychological factors, and poor lifestyle habits all contribute to the complexity of late-stage RA treatment. It is an honour that Professor György Nagy, the head of our institute, developed this concept and popularised the nomenclature of D2T.
Excellent lectures covered topics such as geriatric syndromes: /frailty, /sarcopenia, /osteopenia, and /cognitive decline. In addition to nociceptive and neuropathic pain, nociplastic pain was also discussed—this form of pain results from the sensitisation of both central and peripheral neurological pathways and is characteristic of chronic musculoskeletal diseases.
Highlighted clinical science sessions featured a wide range of topics, including reproductive health, lupus nephritis, rheumatoid arthritis–associated lung disease (RA-ILD), and the emerging interdisciplinary field of cardio-rheumatology. The basic science programme explored subjects such as the role of the microbiome in rheumatic disease and advancements in our understanding of pain receptors. A particularly exciting session reviewed the mechanism of chimeric antigen receptor (CAR) T-cell therapy, which may shape the future of treatment.
This was my second visit to the capital of the USA and my first time taking an inside tour of the United States Capitol—the seat of the United States Congress and the legislative branch of the federal government. I was also fortunate enough to visit two iconic Smithonian museums on the National Mall: the National Museum of African American History and Culture and the National Museum of the American Indian.
What a gorgeous feeling!