Presidential Address
Greetings to all fellow rheumatologists, registrars, physicians with an interest in rheumatology and allied health professionals.
2012 has been filled with a festival of academia supported by the pharmaceutical industry. This is fortuitous from my perspective as like many others, I have recently been audited by the HPCSA for CPD points. For those receiving their frustrating love letters in the post, fear not, attend as many conferences as you can and then simply go onto the SARAA website and you should find your CPD points in a neat row, with hopefully enough ethics points – the recent SARAA congress would have given you a lot.
The BMS sponsored scientific meeting on 16th / 17th March was at the elegant “on Orange” in Cape Town, with superb local presentations (Dr. A. Maharaj and the macrophage phagocytic syndrome sticks in my mind), backed up by Prof Y. Yazici who hails from Turkey but now practices in the USA. It was certainly interesting to hear some of his statistical analyses related to registry data that is often not fully appreciated. He alluded to paradigm shifts in treatment strategies of RA to the more aggressive approach in the USA of commencing biologic therapy following a methotrexate inadequate response. Right or wrong, rheumatologists in South Africa are some way from this very progressive approach. Of particular interest was the local talk on the value of the PPD and Quantiferon tests in predicting latent TB and insights as to how useful (or useless) they actually are.
Arabella was a well-chosen venue by Janssen South Africa for their Connect meeting and definitely enjoyed by all. There were interesting talks by Dr Rob Weiss (dermatologist from Johannesburg) and Dr G. Watermeyer (gastroenterologist from Cape Town) outlining their frustrations in managing their patients without the availability of biologics. Stimulating basic science talks, anecdotes from our overseas guest Prof McGonagle and an opportunity to meet the experts, created superb learning opportunities. This combined meeting of subspecialties showed the rheumatologists to be a cohesive group, definitely ahead in terms of our biologics registry and having experience in not only anti-TNF but other biological agents as well. I returned home with the realization that we have definitely advanced as an Association and have the opportunity to progress further in research originating from our data bases.
There was a rare opportunity to attend a Paediatric Rheumatology meeting on 5th May sponsored by Pfizer at the Westin in Cape Town. I was impressed by the interest shown in this area of rheumatology. As adult rheumatologists we are often confronted with an older child or young teenager and found the symposium very relevant to my practice. Certain difficulties like composite scoring systems which require adaptation to young children for obvious reasons, the differences in responses and uses of different biological agents in children are some of the nuances we may not appreciate. Very interesting presentations from the skyped guest speaker Prof Angelo Ravelli added the international flavor. A positive spin off from the conference is the inclusion of Dr. C. Scott on the biologics panel for approval of JIA cases.
Johannesburg had a chance to host a meeting in July at the grand Radisson Blu Hotel and boast the Gautrain, Sandton Square and fantastic warm winter sunshine. Thanks to Roche who brought out Prof. Ian McInnes and Dr. Andrew Ostor to discuss controversies in Rheumatology. Using Scottish wit to amuse the audience, we were kept entertained by his experience in Glasgow. He explained how social class and the area in which you reside in (even in Glasgow) through genetics and environmental influences, dictates the prevalence of rheumatic disease and in fact life expectancy – something obviously not unique to South Africa.
The grand finale was the Abbott “Power to Treat” conference at the Crystal Towers Hotel in Cape Town on 3rd-5th August. The focus points were “Treat to Target” very well illustrated by Prof Joseph Smolen (past EULAR president), ultrasound imaging by Prof Walter Grassi and spondyloarthropathy by Dr U. Weber. The ultrasound workshop was designed to stimulate interest amongst rheumatologists in this technology, which with some effort and patience should prove invaluable to your everyday practice. The workshop presented by Dr. U. Weber on how to interpret MRI findings of the SI joint was invaluable. The sub-committee with the purpose of formulating the “recommendations for the management of RA” (Prof A. Kalla, Dr B. Hodkinson, Dr. E. van Duuren) were given the opportunity of presenting the new algorithm. Their proposals were well received and even applauded by Prof. J. Smolen.
Last but not least, there will be a further workshop for the rheumatology nurses in November organized by Dr E.van Duuren and Dr B. Hodkinson – dates to be finalized.
The minutes of the SARAA General Meeting held at the Radisson Blu Hotel on 21 July has been posted on the website. Most importantly there was consensus that SARAA should for practical reasons be a Voluntary Association rather than a Section 21 Company. Also the Association should meet at least every 2 years for a BGM and not necessary annually. The standard operating procedure for the biologics panel and the newly proposed consent forms were also presented. Amendments have been made to the constitution and will be duly posted on the website. I would like to thank Elsebe Klink and Dr. R. Benitha for their insight and devotion to these important documents.
A reminder for all to utilize the on-line journals available to all paid up members in the secure part of the website.
I have had the pleasure to work with a fantastic Exco team, Biologics panel and RA Guidelines subcommittee, the benefits of which will be shared by all. Thank you for the support of my peers during my presidency, and please do not be surprised should I sidle up next to you and ask that you take over from me after the Durban combined SARAA / AFLAR congress in April 2013 being organized by Prof. G. Modi.
Yours truly
Clive Pettipher
