Just got back from the Laurentian Conference. As usual, it was a pleasant combination of rheumatology gurus (Paul Plotz), Canadian stars (Janet Pope), and us. The theme of the meeting was "Between skin and bones" and concentrated on scleroderma and inflammatory myopathy. Janet Pope, noted scleroderma researcher, started her talk with the title "Scleroderma: We've come a long way!", and ended her talk with "The outlook is promising". Sandwiched between those statements was no sign of progress and very little hope. In fact, since the last time I heard her speak a couple of years ago, she seems to have dropped cyclophosphamide as a treatment, and is suggesting that methotrexate may, if you look at the evidence in just the right way, have some effect. I guess, though, in scleroderma terms, that's progress. On the other hand, if energy and positive thinking play any part in scientific research, I'm glad Dr. Pope is involved as she provides megadoses of both. On the bright side, well at least the not so dark side, is the canadian scleroderma registry. Started up by Dr. Baron and his associates across the country, we finally see some concerted effort to tackle the problems presented by small numbers of patients. Not much news yet, but maybe this is what's getting Dr. Pope so excited.
Dr. Plotz presented a short history of the study of autoimmunity and his own personal perspective. It was interesting to hear from someone who has an opinion on the big picture, somebody with over forty years of thinking of the big picture. I won't even try to summarize his talk but would suggest you give him a listen if you ever see him giving a similar talk in future meetings. His second talk was on myositis. No groundbreaking news here, after all, he shaped the way we all treat the disease. He suggested though, that infliximab doesn't look great, that cellcept is gaining popularity despite a lack of evidence (and didn't sneer at its use without such evidence). It was nice to see him give exact treatment regimens, right down to the mg/kg. Probably the most interesting statement was that he treats Inclusion Body Myositis, not because he's absolutely convinced that it is treatable, but because, unlike neurologists, he finds it hard not to do something. So after more than forty years of NIH level research, a pillar of evidence-based medicine, Dr. Plotz treats patients because he feels bad for them. Gotta love that.