Episode 59: ASM Roundup - Day 2 with Dr. Marinka Twilt and Dr. Mo Osman

Hosts: Dr. Daniel Ennis, Dr. Janet PopeGuests: Dr. Marinka Twilt (Pediatric Rheumatologist, University of Calgary; ASM Program Committee Chair), Dr. Mo Osman (University of Alberta; Abstract Chair & ASM Planning Committee Co-Chair)We’re coming to you almost live from Halifax for Day 3—the final day of the Canadian Rheumatology Association ASM. The day featured strong podium presentations, a high-yield state-of-the-art lecture on Still’s disease, and a powerful closing keynote on health equity.Podium sessions highlighted emerging science across the spectrum, including sex-based differences in psoriatic arthritis linked to genetic and epigenetic factors, novel monogenic variants in pediatric lupus with neurocognitive involvement, and ongoing inequities in access to therapies for JIA across provinces.The state-of-the-art lecture on Still’s disease emphasized its spectrum across pediatric and adult care, with practical treatment strategies and increasing recognition of associated interstitial lung disease. Key points included the role of HLA-DRB1*15 as a risk marker, the importance of early treatment, and the potential for IL-1 and IL-6 therapies to contribute to complications in select patients.Workshops reinforced these themes, focusing on practical approaches to diagnosing and managing Still’s disease, including lung involvement and the role of JAK inhibitors in refractory cases.The meeting closed with a distinguished investigator lecture from Dr. Cheryl Barnabe, highlighting inequities in care for Indigenous populations and the importance of culturally safe, community-based care to address both geographic and systemic barriers.Main TakeawaysGenetic and epigenetic factors may explain sex differences in psoriatic arthritis Monogenic variants continue to reveal complexity in pediatric lupus Significant inequities persist in access to therapies for JIA across provinces Still’s disease spans pediatric and adult care with shared mechanisms HLA-DRB1*15 may help predict lung complications in Still’s disease Culturally safe, community-based care is essential to improving health equityWhat’s NextCRA ASM 2026 will be held in Vancouver.More highlights coming next year—see you in Vancouver!

Hosts: Dr. Daniel Ennis, Dr. Janet PopeGuests: Dr. Marinka Twilt (Pediatric Rheumatologist, University of Calgary; ASM Program Committee Chair), Dr. Mo Osman (University of Alberta; Abstract Chair & ASM Planning Committee Co-Chair)We’re coming to you almost live from Halifax for Day 2 of the Canadian Rheumatology Association ASM. The day featured diverse podium science, practical workshops, and a lively Great Debate on DMARD tapering.Podium sessions highlighted lupus research on cancer risk, rising costs and work disability in RA, and new biologic insights into flares, with B-cell changes supporting patient-reported disease activity in lupus.Workshops focused on practical tools, including capillaroscopy for early CTD detection, pediatric updates on neonatal lupus risk (anti-Ro vs anti-La), and a structured lab-based approach to unexplained lymphadenopathy.The Dunlop-Dottridge Lecture reviewed statin-associated myositis, emphasizing delayed onset, persistence after discontinuation of the statins, and early IVIG-based treatment.The Great Debate explored DMARD tapering, reinforcing that while guidelines are cautious, real-world care requires shared decision-making and a focus on the lowest effective dose rather than full discontinuation.Main TakeawaysRising costs and ongoing work disability remain significant in RAPatient-reported flares have a clear biological basisStatin-associated myositis can occur years after statin use and requires early IVIGDMARD tapering should be individualized, with focus on lowest effective doseWhat to Watch for on Day 3State-of-the-art lecture on Still’s disease across the lifespanMore high-impact podium presentationsClinical workshops, including one on topical therapiesGala dinner and closing eventsMore highlights coming tomorrow—stay tuned!

Hosts: Dr. Daniel Ennis, Dr. Janet PopeGuest: Dr. Marinka Twilt (Pediatric Rheumatologist, University of Calgary; ASM Program Committee Chair)We’re coming to you almost live from Halifax for Day 1 of the Canadian Rheumatology Association ASM. The day featured key updates across the field, including gaps in pediatric trials, growing recognition of autoinflammatory diseases, and the expanding role of genetics.The SELECT-GCA trial reinforced that upadacitinib is effective for both induction and maintenance of Giant Cell Arteritis (GCA), with high relapse rates after stopping—supporting longer-term treatment. In pediatric ANCA vasculitis, rituximab showed similar efficacy to cyclophosphamide with a safer profile.Sessions on “tough-to-treat RA” highlighted how often non-inflammatory factors drive symptoms, while Clinical Pearls and Medical Mysteries emphasized revisiting diagnoses and the importance of pathology and genetics.The keynote by Dr. Elizabeth Volkman rounded out the day with a focus on holistic care and patient empowerment. Main TakeawaysGCA likely requires longer-term therapy to prevent relapseRituximab is a safe, effective alternative in pediatric ANCA vasculitis“Tough-to-treat RA” often reflects non-inflammatory diseaseReassess when treatments fail—diagnosis evolvesGenetics and pathology are increasingly central to complex casesHolistic care and patient empowerment matter for outcomesWhat to Watch on Day 2New myositis insights, including statin-associated diseasePodium presentations showcasing emerging researchHands-on workshops (including TMJ)Poster tours, with a focus on trainee workThe Great Debate: “Be it resolved that medications should be tapered in patients with inflammatory arthritis in remission.”More highlights coming tomorrow—stay tuned!

Autoinflammatory diseases are often considered rare — but, in clinical practice, they may be far more common than we think. In this episode of Around the Rheum, hosts Dr. Daniel Ennis and Dr. Janet Pope speak with Dr. Jason An, a Toronto rheumatologist with expertise in autoinflammatory disorders.Together, they explore how these conditions differ from classic autoimmune disease, why adult rheumatologists should be thinking about them more often, and how to approach diagnosis when the presentation doesn’t fit neatly into familiar categories.Dr. An also shares practical strategies for recognizing autoinflammatory patterns, interpreting genetic testing, and using targeted therapies both diagnostically and therapeutically.In this episode we discuss:The evolving definition of autoinflammatory disease and how it differs from autoimmune diseaseWhy these disorders are not just pediatric diseases and may present in adulthoodA practical cytokine-based framework for classifying autoinflammatory diseasesThe four major inflammatory “buckets”:IL-1–mediated diseasesIL-18-mediated diseasesTNF / NF-κB pathway disordersInterferonopathiesClinical pattern recognition in patients with recurrent fevers and systemic inflammationThe role and limitations of genetic testing in autoinflammatory diseaseWhy variants of uncertain significance (VUS) may still be clinically meaningful in adultsUsing targeted therapies as diagnostic tools (colchicine, IL-1 blockade, JAK inhibitors)When rheumatologists should consider referral to an autoinflammatory disease specialistRecommended reading:Dr. An’s review on autoinflammatory diseases in The Journal of Rheumatology:https://www.jrheum.org/content/51/9/848Dr. Jason An, MD, MSc is an adult rheumatologist specializing in the diagnosis and treatment of autoinflammatory diseases who works in community practice in the Greater Toronto Area (GTA)Around The Rheum is produced by the CRA Communications Committee. A special thank you to the podcast team, Dr. Dax G. Rumsey (CRA Communications Committee Chair), Dr. Daniel Ennis (Host), Dr. Janet Pope (Host) David McGuffin (exploreproductions.ca), and Erin Stewart (CRA) for leading production.Our theme music was composed by Aaron Fontwell.For more on the work of the Canadian Rheumatology Association, visit rheum.ca

Dr. Kam Shojania is a Clinical Professor at the University of British Columbia, Head of Rheumatology at Vancouver General Hospital, and Medical Director of the Mary Pack Arthritis Program. He co-leads the DART Clinic at St. Paul's Hospital, a combined dermatology-rheumatology clinic focused on complex inflammatory skin and connective tissue diseases. Dr. Sheila Au is a Clinical Professor in the Department of Dermatology and Skin Science at the University of British Columbia and a medical dermatologist at St. Paul’s Hospital. She co-leads the DART Clinic and specializes in inflammatory and autoimmune skin disease, with a focus on morphology-based diagnosis and collaborative care.

A must-listen for anyone treating autoimmune disease or cancer in the era of immunotherapy.

Dans cet épisode d’Autour de la Rhumato, le Dr Hugues Allard-Chamard discute de la santé planétaire et des moyens d’intégrer la durabilité dans la pratique médicale avec les Dres Stéphanie Tom et Elizabeth Hazel.

Did you know that the healthcare industry has a bigger climate change footprint than the airline industry? In this episode of 'Around the Rheum,' hosts Dr. Daniel Ennis and Dr. Janet Pope join in conversation about how rheumatologists can help fight global warming with Dr. Stephanie Tom, the Rheumatology Division Head at Trillium Health Partners in Mississauga, ON and Vice President of the Canadian Rheumatology Association (CRA).

A challenging case from Newfoundland featuring a 22-year-old male with severe fatigue, weight gain, requiring a wheelchair and who had to stop his studies and move back with his parents.

Dr. Gladman is an Emeritus Professor of Medicine at the University of Toronto and and Emeritus Scientist at the Schroeder Arthritis Institute and Crumble Research Institute.