I had initial trepidations about the “virtual meeting.” I have had trouble in past such meetings getting with the program. The ACR staff, Meeting Committee, and Associated Technical Support deserves a standing ovation for how the meeting was put together and presented. There were technical glitches as expected, but overall it was very well done. Being able to rapidly shift from one topic area to another rather than walk half a mile in the convention center allowed accessibility to a wider range of topics of personal interest. The video replay availability of talks also allowed for not having to choose viewing one abstract versus another. The poster session was a much better experience than the massive poster halls. I definitely viewed more posters this year than ever before, as in most years, the poster sessions are, for me, a social event stopping to talk to friends and collaborators rather than seeing the posters. The one to two minute summaries of the posters by the presenters as well as the chat section allowed interaction between presenters and attendees. Live presentations at prior meetings perhaps provided more exposure of trainees to thought leaders due to facial recognition, though I’m not sure that is true.
As far as getting new data across to a large audience, this format was equal or better than live, though it lacked the personal touches, uniting with friends, establishing new collaboration, dinners out etc. that are so valuable in live meetings. My primary area of interest is in lupus and I thought there were more exciting new studies here than in any of the 30 previous meetings I have attended. Multiple examples of new indications for approved medications (belimumab in nephritis) and hopefully soon-to-be-approved medications (vocalosporin) to new exciting targets for therapy in early trials (plasma cells, plasmacytoid dendritic cells, ikaros, and others). These studies also suggest that starting with dual therapies may provide better long-term outcomes than starting with single therapy and adding if treatment fails. Studies on potential new mechanisms of lupus and new biomarkers also provide hope for the future of better indicators of disease activity and response to therapy. The value of second and third renal biopsies in lupus nephritis provided evidence that perhaps we are not doing enough repeat biopsies. Also enlightening were studies in lupus and vasculitis on minimizing corticosteroid exposure and a new oral complement inhibitor that appears promising in vasculitis but has obvious potential value in other diseases such as lupus, hemolytic uremic syndrome.
As anticipated, there were a number of presentations on COVID-19 in relation to susceptibility of our patients to severe disease and proposed management of immunosuppressives during infection. Studies describing the initial enthusiasm for some of our biologics in the treatment of COVID-19 being unrealized when put to the test were well done and informative. Other timely talks and posters involved rheumatologic issues related to checkpoint inhibitor therapy in cancer as an evolving field, and the best approaches to managing these manifestations. Even gout had a big hit in a study from Europe indicating that in a large multicenter trial, there was no increase in cardiovascular events in patients receiving febuxostat versus allopurinol. Diverting again to vasculitis, presentations on the proper diagnostic approach to giant cell arteritis were very informative regarding the diagnostic approach and gold standard ranging from temporal artery ultrasound, to PETCT, to CT angiogram with the eventual goal of replacing temporal artery biopsy as the gold standard. These studies also indicate the systemic nature of the vasculitis. In the end, it still remains that perhaps the best diagnostic is a detailed history and physical exam.
In summary, the new format was about as good as it can get but does not replace the value of one-on-one interactions in person. A combination meeting is one proposal to allow those that value the personal interactions of an in-person meeting while allowing those who prefer the video format to also participate in the meeting at less cost. I would encourage those that did not attend the meeting or have not taken advantage of the multiple outstanding presentations to do so, as there was a lot to learn that impacts how I will practice.
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