Home page Description:
Canadian Rheumatology Association Annual Scientific Meeting discusses latest care practices.
Posted On: September 26, 2016
Image Caption:
Conference attendee, Dr. Kristy Yap, Clinical Research Fellow
Supervisor: Drs. Murray Urowitz, Dafna Gladman, Zahi Touma and Vinod Chandran
Conference Highlight: This year’s Annual Scientific Meeting focused on optimizing quality care in rheumatology. Canadian and internationally renowned rheumatologists came together in Lake Louise, Alberta to review the latest in translational research, case management and therapeutics.
Conference Article: Dr. Cheryl Barnabe reported some interesting data from the Alberta Biologics Pharmacosurveillance Program, which follows more than 1500 rheumatoid arthritis patients, of which 83 are Aboriginals, with a total of 8000 patient-years of observation. Aboriginal patients treated with biologics had the same disease duration as non-Aboriginal patients treated with biologics; however, the Aboriginal patients were more likely to smoke, to have received previous disease-modifying anti-rheumatic drugs prior to starting biologics and to be seropositive. Aboriginals also had a higher rate of hospitalizations, serious infections, thromboembolic events and cancer, but an equal number of cardiovascular events. The take home message was that it is important to study minority groups and understand health disparities so that we can aim to reduce barriers to care.
Guest speaker and sleep physician Dr. Patrick Hanly gave an excellent overview of common sleep disorders. Rheumatologists often don’t get any formal training in sleep medicine, but many rheumatology patients complain of fatigue or sleepiness and it is important for rheumatologists to have a basic understanding of common conditions that affect their patients. Dr. Hanly explained that sleep physicians use multiple tools to evaluate sleep disorders including sleep logs and actigraphy. Sleep at night can be evaluated with a sleep study and polysomnography. The Epworth Sleepiness Scale is a useful tool for differentiating fatigue from sleepiness. Common sleep disorders in Canada include sleep apnea, which is treated with CPAP or BiPAP devices, and restless legs syndrome, which is treated with behaviour modification, avoiding caffeine, treating co-existing medical conditions like sleep apnea and iron deficiency, and identifying any medications which might be interfering with sleep (for example antidepressants and benzodiazepines).
A trendy topic that was discussed at the meeting was the use of medical marijuana for chronic pain. Rheumatologists are often faced with requests from patients for a prescription for medical marijuana. Two thirds of patients using marijuana in Canada today use it for chronic musculoskeletal pain. By 2024, it is estimated that around half a million Canadians will be using medical marijuana. A systematic review done by the Canadian Rheumatology Association found that there were some statistically significant effects on pain and the recent Compass study (2015) concluded that quality controlled herbal cannabis appears to have a “reasonable safety profile.” There are still some downsides to keep in mind. Addiction occurs in 9% of cases and a meta-analysis showed that people with cannabis in their blood stream had five times the risk of a motor vehicle accident. This is an interesting space to watch as the prevalence of chronic rheumatic pain continues to rise and different types of marijuana continue to be developed in Canada.
Conference Article: Dr. Cheryl Barnabe reported some interesting data from the Alberta Biologics Pharmacosurveillance Program, which follows more than 1500 rheumatoid arthritis patients, of which 83 are Aboriginals, with a total of 8000 patient-years of observation. Aboriginal patients treated with biologics had the same disease duration as non-Aboriginal patients treated with biologics; however, the Aboriginal patients were more likely to smoke, to have received previous disease-modifying anti-rheumatic drugs prior to starting biologics and to be seropositive. Aboriginals also had a higher rate of hospitalizations, serious infections, thromboembolic events and cancer, but an equal number of cardiovascular events. The take home message was that it is important to study minority groups and understand health disparities so that we can aim to reduce barriers to care.
Guest speaker and sleep physician Dr. Patrick Hanly gave an excellent overview of common sleep disorders. Rheumatologists often don’t get any formal training in sleep medicine, but many rheumatology patients complain of fatigue or sleepiness and it is important for rheumatologists to have a basic understanding of common conditions that affect their patients. Dr. Hanly explained that sleep physicians use multiple tools to evaluate sleep disorders including sleep logs and actigraphy. Sleep at night can be evaluated with a sleep study and polysomnography. The Epworth Sleepiness Scale is a useful tool for differentiating fatigue from sleepiness. Common sleep disorders in Canada include sleep apnea, which is treated with CPAP or BiPAP devices, and restless legs syndrome, which is treated with behaviour modification, avoiding caffeine, treating co-existing medical conditions like sleep apnea and iron deficiency, and identifying any medications which might be interfering with sleep (for example antidepressants and benzodiazepines).
A trendy topic that was discussed at the meeting was the use of medical marijuana for chronic pain. Rheumatologists are often faced with requests from patients for a prescription for medical marijuana. Two thirds of patients using marijuana in Canada today use it for chronic musculoskeletal pain. By 2024, it is estimated that around half a million Canadians will be using medical marijuana. A systematic review done by the Canadian Rheumatology Association found that there were some statistically significant effects on pain and the recent Compass study (2015) concluded that quality controlled herbal cannabis appears to have a “reasonable safety profile.” There are still some downsides to keep in mind. Addiction occurs in 9% of cases and a meta-analysis showed that people with cannabis in their blood stream had five times the risk of a motor vehicle accident. This is an interesting space to watch as the prevalence of chronic rheumatic pain continues to rise and different types of marijuana continue to be developed in Canada.