What's Hot at ACR 2012

WASHINGTON — Exciting results from trials of rheumatoid arthritis (RA) treatments will be presented here at the American College of Rheumatology (ACR)/Association Rheumatology Health Professionals (ARHP) 2012 meeting, according to program chair Chester V. Oddis, MD, who is from the division of rheumatology at the University of Pittsburgh in Pennsylvania.

One is the first head-to-head comparison of abatacept and adalimumab in RA patients already receiving methotrexate (abstract 2449). "This is a tantalizing abstract that should tell us how 2 biologics stack up against each other," Dr. Oddis said.

Another focuses on the risk for lymphoma in patients receiving anti-tumor necrosis factor (TNF) therapy (abstract 1593). "Cancer is a concern in patients with RA treated with anti-TNF therapy. This study is based on a large cohort of patients and is built on a strong database for ascertainment," Dr. Oddis noted.

A double-blind randomized trial assesses strontium ranelate, which is used to treat osteoporosis. The trial looks at how much strontium ranelate delays radiographic progression of osteoarthritis of the knee (the most common rheumatic disease), compared with placebo (abstract 1596).

In another trial, a new cathepsin inhibitor, called odanacatib, is used to treat osteoporosis in postmenopausal women previously treated with alendronate (abstract 727).

For the first time, the National Institutes of Health has funded a trial — the Rituximab in Myositis (RIM) study. In it, the baseline features of patients with refractory myositis, a rare disease, were examined to identify predictors of response to rituximab treatment (abstract 1598). "This is the largest study of myositis to be conducted, and it involves about 200 patients," said Dr. Oddis, who is a coauthor on the study.

Of the thousands of abstracts submitted, 2700 were chosen for presentation; they can be found on the meeting Web site. The ACR portion of the meeting will consist of 475 oral sessions and 2080 poster sessions.

Pre-ACR Conferences

Pre-ACR Conferences will take place before ACR goes into full gear, Dr. Oddis explained.

The Basic Science Pre-ACR Conference will focus on mesenchymal cells in rheumatic disease. "These cells play a key role in the pathogenesis of connective tissue disease. They modulate fibrosis in our diseases but may also be implicated in tumor metastases," Dr. Oddis noted.

The Clinical Science Pre-ACR Conference is devoted to pain, and covers such topics as the mechanisms and management of pain. "This Conference will feature a multidisciplinary approach to pain and will discuss the latest clinical research techniques in the field of pain, with an overall goal to create better awareness in the management of pain. We hope to stimulate pain research and the adequate reporting of pain in clinical trials," he stated.

Several named lectures will also be of interest. The Gluck Lecture, delivered by Ellen Gravallese, MD, will cover bone physiology and include the mechanisms of destruction and repair of bone in the rheumatic diseases. The Klemperer Lecture, given by Thomas A. Medsger, MD, will deal with autoantibodies in patients with scleroderma and how these can be used to classify patients into subsets to predict outcomes.

The Great Debate Lecture, which will pit cyclophosphamide against rituximab in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis, promises to attract attendees, Dr. Oddis noted.

Sessions will also be devoted to the everyday practice challenges rheumatologists face, such as economic issues and the use of electronic health record systems. In addition, "we always have sessions on practice management that will be helpful to rheumatologists working to streamline their daily clinical care," Dr. Oddis said.

The meeting runs from November 10 to 14, and is expected to attract about 15,000 attendees, similar to last year's meeting.

Dr. Oddis reports being on the advisory boards of Questcor and Genentech.