Checkpoint Inhibitors, Wearables Among Hot Topics at ACR

Marcia Frellick

October 15, 2018

CHICAGO — Cutting-edge information on checkpoint inhibitors, appropriate pain management, and practical applications for wearables will be among the highlights here at the American College of Rheumatology (ACR) 2018 Annual Meeting.

Checkpoint inhibitors have opened up exciting options for the treatment of cancer, especially lung cancer, but they can also trigger some autoimmune complications, said Christine Stamatos, DNP, from Northwell Health in Long Island, New York, who is Association of Rheumatology Health Professionals (ARHP) subchair of the ACR annual meeting planning committee.

"Patients are presenting with significant inflammatory arthritis, myositis, pancreatitis, and interstitial lung disease — all in reaction to these drugs," she told Medscape Medical News.

Several sessions will focus on a pervasive issue in rheumatology: the use of opioids and alternatives to manage pain. One session will focus specifically on pain and elderly patients, Stamatos reported.

Another abstract sheds light on the prevalence of inappropriate pain management in more than 270,000 adults who were treated with different opioid regimens for hip or knee osteoarthritis.

Fatigue is probably the number one complaint for all rheumatic disease.

Speakers will also deliver talks on wearable devices and how to incorporate them into practice.

"Fatigue is probably the number one complaint for all rheumatic disease, so being able to monitor sleep and activity levels is important," said Stamatos.

And during the Great Debate, views on dosing recommendations for hydroxychloroquine, which have been controversial among rheumatologists, will be discussed.

The late-breakers for the three plenary sessions were chosen from thousands of submissions, said Gregg Silverman, MD, from the NYU School of Medicine in New York City, who is basic science subchair of the planning committee.

Late Breakers

Among the late-breaking research will be results from a phase 2 study of a Janus kinase inhibitor for psoriatic arthritis, he told Medscape Medical News.

Another abstract looks at whether rheumatology patients who are getting older and whose immune systems are impaired need a high-dose influenza vaccine. "Rheumatoid arthritis patients are particularly at risk," said Silverman.

Attendees will also hear how activation of the immune system affects the bone in rheumatic disease and how biologic agents are used to treat patients with subsequent effects on the bone.

And a talk on the microbiome — specifically aspects of host–microbe interactions revealed with new technologies and the role of the microbiome in conditions such as esophageal reflux and Clostridium difficile colitis — will be delivered by Martin Blaser, MD, from the NYU School of Medicine.

The conference will officially kick off with an opening talk by veteran Hollywood film and television producer Jonathan Koch, who is president and chief creative officer at Asylum Entertainment. Koch survived an acute, life-threatening medical crisis with macrophage activation syndrome and hemophagocytic lymphohistiocytosis that led to the amputation of his hands and feet and an eventual hand transplant.

He will give personal testimony on how providers can foster resilience in their patients.

Stamatos and Silverman have disclosed no relevant financial relationships.

Follow Medscape Rheumatology on Twitter @MedscapeRheum and Marcia Frellick @mfrellick

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