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ACR 2017: Biosimilar Debate, Inflammation in OA, and More

— Special lecture will look back at TNF as rheumatology drug target

MedpageToday

SAN DIEGO -- Rheumatologists from around the country -- and around the world, totaling almost 17,000 attendees from 100 countries -- will gather here this weekend for the opening of the 2017

Late Saturday afternoon, the opening lecture will be given by world-renowned researcher Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, who will discuss "Emerging and Re-emerging Infectious Diseases from AIDS to Zika." Zika virus can cause severe joint symptoms, pointed out Richard F. Loeser, Jr., MD, director of the Thurston Arthritis Research Center at the University of North Carolina, Chapel Hill, who chairs the meeting's program committee. This will be followed by the opening reception, giving participants a major networking opportunity.

Sunday morning will feature the popular "Year in Review" session, with basic science to be discussed by Richard M. Pope, MD, of Northwestern University in Chicago, and the clinical aspects to be reviewed by Daniel H. Solomon, MD, of Brigham and Women's Hospital and Harvard Medical School in Boston. The speakers chose the papers from the previous year's literature they consider to be the most important and influential. "It's a great way for people who haven't had a chance to keep up with everything in the literature to get nice summaries of the most important findings of the last year," Loeser told MedPage Today.

A highlight on Sunday will be this year's Great Debate, entitled "Biosimilars: To Switch or Not to Switch?" with Jonathan Kay, MD, of the University of Massachusetts in Worcester, and Roy Fleischmann, MD, of the University of Texas Southwestern Medical Center in Dallas. Kay will offer the "pro" side: "It is important for healthcare professionals and patients to understand what biosimilars are and what they are not, so that appropriate treatment decisions can be made," he said in a press release.

Fleischmann, who will provide the "con" point of view, noted that there has been less enthusiasm for biosimilar uptake in the U.S. than in other countries: "The reasons for this are multifactorial, including questions on long-term safety, efficacy, and economic savings."

Monday morning will feature the Paul Klemperer Memorial Lecture, to be delivered by Sir Ravinder N. Maini, MBBCh, of Imperial College London, speaking on "The Discovery of TNF Inhibitors: Conquering Rheumatoid Arthritis by Molecular Targeting."

Maini was one of the discoverers of the role of tumor necrosis factors in rheumatoid arthritis, work for which he was knighted. "Blocking TNF has probably been the biggest breakthrough in arthritis since anyone can remember," Loeser said.

Another focus of the meeting will be presentations on precision medicine. "We have all these new treatments, but it's going to be important to target the right treatment to the right patient," he said. "We're finding more and more that people respond differently to different treatments for arthritis, and it would be so much more effective -- both cost-wise and side effects-wise -- if we could pick out [the appropriate patients] for each new treatment that comes along."

On Tuesday morning, a session of interest will be "Osteoarthritis: Beyond the Guidelines," with presentations by Steven B. Abramson, MD, of New York University, who will discuss the role of inflammation in the pathogenesis of OA, and Timothy McAlindon, MD, of Tufts University in Boston, who will review new treatments targeting inflammation in OA.

"In the past, people didn't really think about osteoarthritis as having an inflammatory component, but we're learning that it does, and new treatments are being developed that target the inflammatory side of osteoarthritis," Loeser explained.

Finally, on Tuesday afternoon the late-breaking abstracts will be presented. Among the topics of these eagerly awaited presentations are intra-articular sprifermin in knee OA, risankizumab for psoriatic arthritis, secukinumab for ankylosing spondylitis, a reversible B-cell inhibitor in IgG4-related disease, rapamycin for inclusion body myositis, and ustekinumab for systemic lupus erythematosus.