The American College of Rheumatology’s 2018 Annual Meeting occurred in Chicago, Illinois on October 19-24, 2018. Nearly 16,000 attendees gathers to share and discuss the latest scientific advances, clinical issues, and medical education topics in rheumatology.

A highlight of Division of Rheumatology members' 12 posters, 3 oral presentations, and one panel discussion at ACR included a research study by Trevor McKown, MD, internal medicine resident, and Christie Bartels, MD, MS, assistant professor, Rheumatology.

Dr. McKown happens to the be the son of Rheumatology division chief Kevin McKown, MD.

"Posters on tobacco cessation in rheumatology clinics and accelerated end organ lupus damage in smokers presented by Chief Resident Dr. Ann Chodara and Dr. Trevor McKown, respectively, were very well received. McKown’s study demonstrated a 4 year difference in event-free survival among never and current smokers, and showed a pack-year dose relationship," said Dr. Bartels.

Three abstracts from UW-Madison investigators were selected for oral presentations, including a pilot study of an arthritis activity intervention, health care provision to patients with lupus living in an urban setting, and a study by Miriam Shelef, MD, PhD, assistant professor, Rheumatology, on peptidylarginine deiminases and their role in rheumatoid arthritis.

"Trends from the meeting overall included several discussions about interstitial lung disease, nephritis, and medication adherence in rheumatology resonating with work of UW rheumatology junior faculty Drs. Sara McCoy and Shivani Garg," said Dr. Bartels.

Her team's oral presentation on examining predictor of gaps in lupus retention in care generated interest from many centers and leaders focused on health disparities, she explained. "We found that the UW-derived area deprivation index (ADI), a marker of neighborhood disadvantage, was the strongest predictor of gaps in care. Our innovation applying retention in care to lupus and using the ADI generated significant interest for future collaborations.

"Success of many of our projects also highlights the incredible multidisciplinary expertise in UW DOM including collaborators at CTRI (Dr. Megan Piper), in nephrology (Drs. Sara Panzer and Tripti Singh), and our health services group (Dr. Amy Kind and colleagues)," she said.

Sara McCoy, MD, assistant professor (CHS), Rheumatology, was struck by advances in clinical care. "Many autoimmune diseases such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS) have improved outcomes with early recognition and treatment. At the 2018 ACR, research is moving toward improving risk stratification through B cell receptor analysis, and genetic profiling in AS and RA, respectively," she said.

Dr. McCoy leads a specialty clinic for patients living with Sjogren’s syndrome, a greatly female-predominant autoimmune disease that typically onsets during menopause. "Many rheumatologists were interested to discover that my research has demonstrated that female sex hormones may be protective against development of SS. We also received positive feedback on our data supporting the clinical practice of using mycophenolate and azathioprine for treatment of ILD in Sjogren’s patients," she said.

Other attendees noted breakthroughs presented by the UW contingent. "Dr. Bartels is making an impact in the field of rheumatology through her research showing success of tobacco cessation and hypertension protocols implemented in rheumatology clinic. Dr. Shelef gave a very well received oral presentation regarding the impact of peptidylarginine deiminases impact on IgG half-life along several provocative posters involving peptidlyarginine deiminase’s role in rheumatoid arthritis. And Dr. Garg presented her data examining delayed time to biopsy in lupus nephritis as well as her data on prevalence and predictors of renal arteriosclerosis," said Dr. McCoy.

Poster and abstract information:

• Amlani/Elsayed/McCoy, "Azathioprine and Mycophenolate for Management of Sjogren’s Syndrome-Related Interstitial Lung Disease: A Retrospective Cohort Study"
• McCoy, "Sjogren’s Syndrome Is Associated with Reduced Sex Hormone Exposure: A Case-Control Study
• Ahmad and Bartels, "Defining and Examining Retention in Care in an Urban Lupus Cohort"
• Bawadekar/Bridges/Shelef, Serum Immunoglobulin G Targets Citrulline-Containing Immunoglobulin G Peptides in Rheumatoid Arthritis Patients Who Test Positive for Rheumatoid Factor and AntiCyclic Citrullinated Peptide Antibodies
• Trevor McKown/Bartels, "Smoking Status Predicts Earlier SLICC Damage Index Progression in a Large SLE Cohort"
• Bawadekar/Shelef , "Peptidylarginine Deiminases Are Required for Normal Immunoglobulin G Half-Life"
• Perez/Bartels, "Helping a Non-Urban Community Walk with Ease: A Feasibility Pilot Study of an Arthritis Activity Intervention"