Hosts: Dr. Daniel Ennis, Dr. Janet Pope

Guests: 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. SLIC1 also emerged as a potential biomarker for pulmonary involvement in myositis.

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, 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 Takeaways

Rising costs and ongoing work disability remain significant in RA

Patient-reported flares have a clear biological basis

SLIC1 may emerge as a biomarker for lung involvement in myositis

Capillaroscopy is a valuable tool for early CTD detection

Statin-associated myositis can occur years later and requires early IVIG

DMARD tapering should be individualized, with focus on lowest effective dose

What to Watch on Day 3

State-of-the-art lecture on Still’s disease across the lifespan

More high-impact podium presentations

Clinical workshops, including topical therapies

Gala dinner and closing events

More highlights coming tomorrow—stay tuned!

Hosts: Dr. Daniel Ennis, Dr. Janet Pope

Guest: 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 Takeaways

• GCA likely requires longer-term therapy to prevent relapse
• Rituximab is a safe, effective alternative in pediatric ANCA vasculitis
• “Tough-to-treat RA” often reflects non-inflammatory disease
• Reassess when treatments fail—diagnosis evolves
• Genetics and pathology are increasingly central to complex cases
• Holistic care and patient empowerment matter for outcomes

What to Watch on Day 2

• New myositis insights, including statin-associated disease
• Podium presentations showcasing emerging research
• Hands-on workshops (including TMJ)
• Poster tours, with a focus on trainee work
• The 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 disease
• Why these disorders are not just pediatric diseases and may present in adulthood
• A practical cytokine-based framework for classifying autoinflammatory diseases
• The four major inflammatory “buckets”:
• IL-1–mediated diseases
• IL-18-mediated diseases
• TNF / NF-κB pathway disorders
• Interferonopathies
• Clinical pattern recognition in patients with recurrent fevers and systemic inflammation
• The role and limitations of genetic testing in autoinflammatory disease
• Why variants of uncertain significance (VUS) may still be clinically meaningful in adults
• Using targeted therapies as diagnostic tools (colchicine, IL-1 blockade, JAK inhibitors)
• When rheumatologists should consider referral to an autoinflammatory disease specialist

Recommended reading:

Dr. An’s review on autoinflammatory diseases in The Journal of Rheumatology:

https://www.jrheum.org/content/51/9/848

Dr. 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

In this episode of Around the Rheum, Dan and Janet sit down with Dr. Kam Shojania and Dr. Sheila Au from the DART (Dermatology–Rheumatology) Clinic at St. Paul’s Hospital in Vancouver to explore how the dermatologic lens can transform rheumatology practice.

From alopecia to facial rashes, morphea to lichen planus, this conversation unpacks the some of the diagnostic traps rheumatologists commonly fall into — and how a morphology-first approach can improve accuracy and patient care.

We discuss:

• Why “maculopapular” isn’t a great descriptor
• Scarring vs. non-scarring alopecia in lupus
• Rosacea and other mimics of the malar rash
• Lichen planus, morphea, and eosinophilic fasciitis
• The difference between “lumpers” and “splitters” in medicine
• When to biopsy — and how deep it needs to be

If you see rashes in your clinic patients — this episode will change how you think about them!

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.

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

In this special episode of Around the Rheum, hosts Dr. Daniel Ennis and Dr. Janet Pope sit down with guideline co-authors Dr. Carrie Ye and Dr. Jeff Graham to break down the newly released Canadian Rheumatology Association/Canadian Research Group of Rheumatology in Immuno-Oncology (CanRIO) Living Guidelines for the management of baseline immunosuppression in individuals with pre-existing rheumatic diseases initiating immune checkpoint inhibitors (ICIs).

Together, they unpack the key tensions clinicians face: balancing cancer treatment efficacy with the risk of flare of autoimmune disease, the challenges of low-quality and limited data, and the nuances of caring for patients whose autoimmune conditions behave very differently. From inflammatory arthritis to systemic autoimmune rheumatic diseases (SARDs), the panel highlights when to consider de-escalation, when to continue treatment, and how oncologists and rheumatologists can collaborate to support patient outcomes.

They also discuss what surprised them during the systematic review, what evidence is still missing — especially around oncologic outcomes — and how clinicians can access and stay update to date on these living guidelines.

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

Dr. Carrie Ye is a rheumatologist and Associate Professor at the University of Alberta. She practices at the Kaye Edmonton Clinic and runs a specialized Rheumatology & Immuno-Oncology Clinic, focusing on the intersection of autoimmune disease and cancer immunotherapy. Dr. Ye is a leading member of the CanRIO Research Group and a senior author of the new living guidelines discussed in this episode. 

Dr. Jeff Graham is a medical oncologist at CancerCare Manitoba and an Assistant Professor at the University of Manitoba. His clinical and research expertise focuses on genitourinary cancers, particularly kidney cancer and immunotherapy. He serves as the oncology lead on the CanRIO guideline team, bringing critical insight into cancer outcomes and treatment-risk balancing for patients receiving checkpoint inhibitors.

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

Saviez-vous que le secteur des soins de santé a une empreinte climatique plus importante que celle de l’industrie aérienne?

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. Ensemble, ils explorent les liens entre la santé humaine et celle de notre environnement, et réfléchissent à la responsabilité du milieu de la santé face aux changements climatiques.

La boîte à outils: Des soins de santé durables : Guide de mise en œuvre en rhumatologie.

La Dre Stéphanie Tom, vice-présidente de la Société canadienne de rhumatologie, explique comment elle s’est intéressée à la durabilité après avoir découvert l’empreinte carbone importante du secteur de la santé. Elle partage des gestes concrets pour réduire l’impact environnemental des cliniques, comme la diminution de l’usage des produits jetables.

La Dre Elizabeth Hazel, professeure associée à l’Université McGill, souligne pour sa part l’importance d’intégrer ces principes dans la formation médicale et de prêcher par l’exemple, que ce soit en encourageant l’activité physique ou en adoptant des comportements écoresponsables au quotidien. 

Ensemble, elles rappellent que protéger la planète, c’est aussi protéger la santé de nos patients et la résilience de nos systèmes de soins.

L’épisode met en lumière des solutions accessibles et des ressources comme CASCADES, la Société canadienne de rhumatologie et l’Association médicale canadienne, qui accompagnent les professionnels vers une pratique plus durable.

Pour réagir à l’épisode ou proposer des sujets, écrivez à [email protected] ou suivez-nous sur X (Twitter) à @autourdelarhumato.

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).

In 2022, Dr. Tom led the creation of the CRA Planetary Health Committee that has now published a toolkit to help rheumatologists lessen our climate change impact. Dr. Tom discusses the concept of planetary health and its application in rheumatology. She emphasizes cost savings and sustainable practices such as de-prescribing and high-value patient care. Through practical examples, the conversation highlights efforts to reduce waste and improve efficiencies in clinical practice. Dr. Tom also introduces the CRA's new toolkit designed to help rheumatologists lessen their climate impact, and offers actionable advice for greening offices and advocating for environmental stewardship in healthcare.

This episode of Around The Rheum was generously supported by Choosing Wisely Canada and The Royal College Foundation.

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 www.rheum.ca

We're back with another fascinating medical mystery in this episode of Around the Rheum! Hosts Dr. Daniel Ennis and Dr. Janet Pope are joined by Dr. Steven Rowe, an internal medicine resident at Memorial University of Newfoundland (MUN), as they delve into a challenging case of a 22-year-old male with severe fatigue, requiring a wheelchair, who had to stop his studies and move back with his parents. The patient presented with multiple perplexing symptoms, including significant weight gain, intermittent abdominal discomfort, dyspnea, and peripheral edema. Will Dan and Janet solve the case before Dr. Rowe reveals the ultimate and surprising diagnosis? Voicing your theories out loud as you listen along is definitely encouraged!

If you have questions you would like answered or guest suggestions, please get in touch through the CRA social media accounts or by email: [email protected].

A special thank you to the podcast team, Dr. Dax G. Rumsey (CRA Communications Committee Chair), Dr. Daniel Ennis (Host), Dr. Janet Pope (Co-Host), David McGuffin (Producer, ExploreProductions.ca), and Erin Stewart (Marketing and Communications Director, CRA) for leading production. Our theme music was composed by Aaron Fontwell. For more on the work of the Canadian Rheumatology Association, visit www.rheum.ca

In this episode of Around The Rheum, Dr. Daniel Ennis and Dr. Janet Pope are joined again by living legend in the world of Rheumatology, Dr. Dafna Gladman. Dr. Gladman is an Emeritus Professor of Medicine at the University of Toronto and an Emeritus Scientist at the Schroeder Arthritis Institute and Crumble Research Institute. Dr. Gladman, who recently delivered the Dunlop-Dottridge lecture at the CRA's 2025 Annual Scientific Meeting in Calgary, discusses the past, present, and future of psoriatic arthritis (PsA) research. She highlights the role of biomarkers, the vital and complementary contributions of clinicians and statisticians in conducting research, and the emerging role of AI in transforming PsA patient care. Dr. Gladman also reflects on her career journey, the importance of collaboration in medical research, and her recent appointment as an officer of the Order of Canada.

If you have questions you would like answered or guest suggestions, please get in touch through the CRA social media accounts or by email: [email protected].

A special thank you to the podcast team, Dr. Dax G. Rumsey (CRA Communications Committee Chair), Dr. Daniel Ennis (Host), Dr. Janet Pope (Co-Host), David McGuffin (Producer, ExploreProductions.ca), and Erin Stewart (Marketing and Communications Director, CRA) for leading production. Our theme music was composed by Aaron Fontwell. For more on the work of the Canadian Rheumatology Association, visit www.rheum.ca

In this episode of Around the Rheum, hosts Daniel Ennis and Janet Pope welcome Alison Clifford, a rheumatologist specializing in large-vessel vasculitis (LVV), particularly giant cell arteritis (GCA). Recorded live at the Canadian Rheumatology Association (CRA)'s 2025 Annual Scientific Meeting (ASM) in Calgary, the discussion delves into Dr. Clifford's research on LVV, the use of new radiotracers, and the complexities of diagnosing and managing LVV. The conversation also covers the challenges of distinguishing vasculitis from other conditions, the importance of inter-professional collaboration, and strategies for long-term monitoring and treatment of patients with LVV. The episode concludes on the need for more evidence in this challenging area of medicine! Sit back, relax, and enjoy!

Dr. Alison Clifford is a rheumatologist and associate professor in the faculty of medicine at the University of Alberta. She has a research and clinical focus on Vasculitis, particularly giant cell arteritis. And she is an associate member of CanVasc.

If you have questions you would like answered or guest suggestions, please get in touch through the CRA social media accounts or by email: [email protected]. 

A special thank you to the podcast team, Dr. Dax G. Rumsey (CRA Communications Committee Chair), Dr. Daniel Ennis (Host), Dr. Janet Pope (Co-Host), David McGuffin (Producer, ExploreProductions.ca), and Erin Stewart (Marketing and Communications Director, CRA) for leading production. Our theme music was composed by Aaron Fontwell. For more on the work of the Canadian Rheumatology Association, visit www.rheum.ca