October 22 Daily Buzz at ACR 2018

Liz Neporent

October 22, 2018

Day 3 at ACR 2018.


CHIGACO — The American College of Rheumatology (ACR) 2018 Annual Meeting is in full swing on its third day with dozens of sessions highlighting the latest rheumatology research and clinical applications. Not only are attendees connecting with colleagues and experts in person, nearly 1500 Twitter users have tweeted more than 6000 times using the official #ACR18 hashtag since the conference began.

An analysis of data from the Rheumatology Informatics Systems for Effectiveness (RISE) national registry shows that nearly half the patients with rheumatoid arthritis (RA) with moderate to high disease activity at an index visit had no change in medication in the subsequent 7 to 12 months to lower disease activity, despite a treat-to-target goal.

Here's What We Were Waiting For

Jeffrey Curtis

This finding shines a spotlight on the relatively high proportion of RA patients whose therapy is not changed even though lower disease activity or remission is not achieved, said study coauthor Jeffrey Curtis, MD, from the University of Alabama at Birmingham.

It speaks to a concern of clinical inertia, he added.

Asked why almost 50% of RA patients don’t meet treatment goals, Curtis told reporters attending a news conference today that the answer, in part, is to empower patients to be their own advocates.

"We definitely need more interventions where patients are encouraged to switch therapies and want to do better," he said.

Medscape Medical News met one-on-one with Curtis to go over the numbers and hear his insights, and will report that story shortly.

An Unexpected Find

Most of the research presented on fibromyalgia centers on factors like diagnosis, treatment, and measurement. However, one group of researchers made the case that patients with this condition are misunderstood.


Despite having a reputation as whiners and complainers, the team found that only about 14% of fibromyalgia patients are considered to be exhausting and difficult to deal with by clinical rheumatology staff. Most — 86.3% — were rated by a rheumatologist and a nurse as moderate or easy to care for. Furthermore, these patients valued the care they received, according to evaluations of more than 350 fibromyalgia patients followed in a rheumatology office practice.

Asked why fibromyalgia patients get such a bad rap, lead author Robert Katz, MD, from Rush Medical College and Northwestern University's Feinberg School of Medicine in Chicago, said he thinks it is because the disease is so difficult to diagnose.

"It's not a psychological condition, as we rheumatologists know, and it's not the patient being crazy," he told Medscape Medical News. "When you listen and then come up with a diagnosis and treatment strategy, most patients are appreciative."

The ACR's RISE Registry receives funding from Eli Lilly. Curtis reports financial relationships with Eli Lilly, AbbVie, Amgen, BMS, Corrona, Genentech, Janssen, Myriad, Pfizer, Radius, Roche, and UCB. Katz has disclosed no relevant financial relationships.

Follow all of Medscape's coverage on the ACR 2018 conference page and on our Twitter, Instagram, and Facebook accounts.

Follow Medscape Rheumatology on Twitter @MedscapeRheum and Liz Neporent @LizzyFit


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.