Associate Professor Mihir Wechalekar will speak at the upcoming ARA ASM about personalising therapy and the frontiers of our understanding.
Delegates at this weekend’s ARA annual scientific meeting in Adelaide can find out all about the latest science and future directions in rheumatoid arthritis.
Associate Professor Mihir Wechalekar, rheumatology consultant at the Southern Adelaide Local Health Network, spoke to Rheumatology Republic ahead of the meeting to give a sneak peek at his Sunday afternoon session with Professor Michael Brenner and Professor Ranjeny Thomas.
With the way RA is currently managed, outcomes were “very unsatisfactory”, Professor Wechalekar said.
“With so-called highly targeted – and even combination – biologic therapy, our remission rates are hardly 30% or 40%,” he said.
The main issue was the non-targeted use of biologics and standard therapy. Professor Wechalekar said high-quality research using biobank samples of synovial tissue suggests targeted therapies have better outcomes, particularly with certain treatment subtypes.
“The difference is actually quite striking,” he said. “There are some patients who, even with a brief burst of treatment, appear to go into long term remission. It appears to turn off the disease.”
Professor Wechalekar will be presenting some findings from his research, which is still underway, and discuss potential future directions for RA treatment.
One exciting vision for the future is better biopsy techniques that analyse samples on a deep molecular level for better tissue subtyping and understanding of cellular interactions.
Other promising research, hints at a potential early biomarker for treatment resistance, which could lead to more intensive or combination treatment provided to patients to achieve remission early, he said.
Professor Wechalekar will be joined by other colleagues in the session on rheumatoid arthritis, which is also dedicated to discussing how to achieve remission and predict flares.
US rheumatologist Professor Michael Brenner will discuss identifying pathways that block fibroblast-mediated inflammation and joint damage in RA and other diseases.
Professor Brenner has published numerous high-impact articles on these cells, which were important because they had not traditionally been seen as a target in RA, Professor Wechalekar said.
“Part of the reason may be that it is a target that’s not an immune cell, as such. So, one may be able to target that particular type of cell with better outcomes, without immunosuppression.”
Queensland rheumatologist Professor Ranjeny Thomas, who Professor Wechalekar described as a key driver in the attempted development of a vaccine for RA, will discuss the use of antigen-specific immunotherapy for the condition.
“It is quite critical in that, if using the right person at the right stage of their disease, they may be able to achieve disease remission without pharmacotherapy,” Professor Wechalekar said. “We could do the same job in a much better, nicer and safer way with immunotherapy.”
ARA 2025 runs from 3-6 May in Adelaide, South Australia. See the meeting website for further details regarding the program, presenters and how to register.
