Takeaways from the IRACON

Irlapati Rajendra Vara Prasad MD, DM (Rheumatology), APLAR Fellowship, Centre for Rheumatology, UCL, London, UK
Consultant Rheumatologist, Yashoda Hospitals, Hyderabad, Telangana

IRACON 2023, held from November 23rd to November 26th, was a comprehensive exploration of advancements and challenges in the field of rheumatology and truly reflects its theme – ‘Crossing Frontiers in Rheumatology’. The conference began with hands-on workshops on Day 1, covering diverse topics such as MRI, ultrasound, research and publication, osteoporosis, autoantibodies, soft tissue rheumatism, GRAPPA and connective tissue diseases with interstitial lung disease (CTD ILD). Additionally, a well-attended preconference Continuing Medical Education (CME) session for physicians set the stage for the scientific sessions that followed.

The conference was marked by eminent international speakers like Laurent Arnaud, Joan T Merrill, Chetan Mukhtyar, Atul Deodhar, Amit Garg, AV Ramanan, Dennis Poddubnyy, Maya Buch and several others. On the national front, along with the exemplary senior faculty a lot of young minds were speakers in the event.

The scientific sessions commenced with review of Indian research in 2023. The Presidential Oration, “Rheumatology in Crossroads – Cusp of Change?” delved into the evolutionary phases of rheumatology, emphasizing the rheumatologist’s role as a primary care provider. The importance of evidence-based medicine and collaborative research, particularly major studies from India, was underscored. In the context of Systemic Lupus Erythematosus (SLE), precision medicine and immunological profiles were discussed, pointing to the potential for large clinical trials in India. The IRA Oration was delivered by Dr Vinod Ravindran, Kolkon oration by Dr Sarath Chandra Mouli and the IRA Young Investigator award was given to Dr Shankar Naidu

SLE in 2023:

The discussions on SLE highlighted the persisting unmet needs and the promising developments, with 94 drugs in the pipeline. Notable drugs such as belimumab, voclosporin, anifrolumab, were discussed. The focus on lupus nephritis included insights into CKD-free survival rates, common patterns of injury, and innovative treatments like SGLT-2 inhibitors and liquid biopsy for lupus nephritis (panel of urinary biomarkers).

Takayasu Arteritis and Large Vessel Vasculitis:

A panel discussion dedicated to Takayasu arteritis emphasized the need to sensitize other specialties, conduct careful clinical examinations, and plan consensus treatment guidelines. Another intriguing session questioned whether Takayasu Arteritis (TAK) and Giant Cell Arteritis (GCA) are the same, discussing diagnostic challenges and the impact of age on diagnosis.

Rheumatoid Arthritis (RA) Updates:

RA-related sessions covered a spectrum of topics, from cardiovascular risks and the use of low-dose glucocorticoids to treatment cost analysis and strategies for refractory RA. Discussions on biomarkers, treatment analyses, and precision medicine in RA shed light on the evolving landscape of RA care.

Axial Spondyloarthritis (AxSpA) and Psoriatic Arthritis (PsA):

AxSpA discussions emphasized the close relationship between inflammation and structural damage. Distinct subtypes of spine involvement in PsA were identified, providing insights into the imaging features and demographics associated with classical and nonclassical spine involvement.

Myositis, Uveitis, and Other Topics:

Insights into myositis highlighted the potential of rituximab and tofacitinib, while the session on uveitis provided a comprehensive approach to diagnosis and treatment. Sessions on scleroderma lung disease, antiphospholipid syndrome (APS), IgG4 disease, and the innate immune response in thrombotic microangiopathy broadened the spectrum of discussions.

Advancements in Basic Sciences:

The conference showcased notable research contributions from India, covering a range of topics such as angiogenesis in Takayasu arteritis, human leukocyte antigen associations in systemic sclerosis, synovial fluid-derived microparticles in rheumatoid arthritis, and more. These studies underscored the growing significance of basic science research in understanding rheumatological disorders.

Closing Thoughts:

IRACON 2023 provided a comprehensive platform for rheumatologists, researchers, and healthcare professionals to delve into the latest advancements, challenges, and collaborative opportunities in the field. The conference’s diverse sessions reflected the multifaceted nature of rheumatology, from precision medicine in lupus to emerging treatments in vasculitis and insights into the basic science underpinning rheumatic diseases. As the conference concluded, it left a lasting impact on the participants, fostering a sense of shared knowledge and a commitment to advancing rheumatological care globally.