Program Agenda

Opening Remarks

Welcome to CARC 2024!

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11:30am-11:45am EDT

• ​Welcome to CARC & Land Acknowledgement

• Opening Remarks by Dr. Mohit Kapoor, Dr. Hetty Mulhall, Laurie Proulx, and John Yan 

• Housekeeping + Introduction to Keynote Session

Keynote Session 

Moderator: Laurie Proulx 

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The Successes in the Pain Community from the Work of the Canadian Pain Taskforce by Linda Wilhelm & A Top-Down/Bottom-Up Approach to Identifying and Addressing Pain Priorities by Jean-Francois Leroux 

Linda Wilhelm and Jean-Francois Leroux (in collaboration with Maria Hudspith) 
11:45-12:25 EDT

Session Descriptor: In March 2021, the Canadian Pain Task Force published its final report “An Action Plan for Pain in Canada” which included over 150 recommendations on priority actions. This session will provide an overview of the journey that contributed to the identification of pain priorities, as well as the advancement of actions to enhance the prevention and management of chronic pain in Canada.

At the end of this session, participants will be able to: 

• Learning Objective 1: Describe the roles and responsibilities of different stakeholders in driving policy changes in pain-related areas. 

• Learning Objective 2: Describe the importance of including people with lived experience in all aspects of the work related to pain.

• Learning Objective 3: Communicate progress made to enhance the prevention and management of chronic pain in Canada.

Health Break

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12:25-12:30 EDT

Early Diagnosis and Biomechanics in Arthritis

Moderator: Natalie Boivin

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Yes, We Can! A "Hub-Spoke" Model of Care for Northern Ontario 

Dr. Sahil Koppikar
12:30-12:45 EDT

Session Descriptor: This session will review the barriers to accessing rheumatological care in northern Ontario and look at how extended-role practitioners can help improve access and outcomes. The speaker will describe a new model of care being implemented in northern Ontario and its impact and challenges.

At the end of this session, participants will be able to: 

• Learning Objective 1: Describe the barriers and impact of rheumatological care in northern Ontario.

• Learning Objective 2: Explain how extended-role practitioners in a multidisciplinary model of care can help improve access and outcomes in remote and rural communities.

• Learning Objective 3: Recognize the impact and challenges of implementing novel models of care in northern Ontario.   

Omic Strategies in Early Detection of Arthritis

Dr. Vinod Chandran
12:45-13:00 EDT

Session Descriptor: Early detection and diagnosis of inflammatory arthritis leads to better outcomes. Biomarkers may help identify patients at high risk or help in the early diagnosis of arthritis. This session will discuss strategies for early detection of arthritis by analyzing and integrating studies of -omes (genomes, transcriptome, proteome, metabolome, etc.) using bioinformatics and computational biology.

At the end of this session, participants will be able to: 

• Learning Objective 1: Appreciate that early diagnosis of inflammatory arthritis leads to better outcomes and identify the current unmet needs. 

• Learning Objective 2: Understand how biomarkers help in early diagnosis. 

• Learning Objective 3: Understand how omic might help identify potential diagnostic biomarkers. 

The Biomechanical Fingerprint of Osteoarthritis

Dr. Jesse Charlton 
13:00-13:15 EDT

Session Descriptor: The biomechanical consequences of osteoarthritis can be complex, often with unique presentations between people – a biomechanical fingerprint. However, with common underlying patterns that are modifiable, we can target rehabilitation to improve biomechanics and hopefully the disease course. This session will provide a whistle-stop tour of biomechanics in osteoarthritis and how Dr. Charlton and others are tackling it with their pan-Canadian team.

At the end of this session, participants will be able to: 

• Learning Objective 1: Identify key biomechanical features of the disease course. 

• Learning Objective 2: Recognize biomechanically-rooted opportunities for rehabilitation. 

• Learning Objective 3: Explore recent team-science approaches to biomechanical investigations. 

Panel: Ask Me Anything

13:15-13:30 EDT

Lunch Break 

13:30-14:00 EDT

Best Research Presentations

Moderator: Dr. David Hart

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Building Capacity for Patient Partnership: A Grassroots Initiative by and for the Community 

Laurie Proulx and Linda Roy
14:00-14:15 EDT

Session Descriptor: The Canadian Arthritis Patient Alliance (CAPA) has been working with health research teams in Canada and other countries for a long time to bring real-life experience with arthritis to help make research better. This session will describe a training program offered by CAPA to prepare patient partners for health research. The program will be described, including the on-line training and mentorship, and matching patient partners to research and other patient-focused projects. 

At the end of this session, participants will be able to: 

• Learning Objective 1: Improve their understanding of patient engagement in research. 

• Learning Objective 2: Identify opportunities and gaps to support patient partners to meaningfully contribute to research. 

• Learning Objective 3: Identify future directions and opportunities to equip patient partners to contribute to research. 

Candidate Epigenetic Polygenic Risk Score (E-PRS) to Predict Pain Response Following Surgical Intervention for Lumbar Spinal Stenosis due to Spine Osteoarthritis Intervention

Dr. Noah Fine
14:15-14:30 EDT

Session Descriptor: Surgery for spine osteoarthritis (OA) can be an effective treatment, however one third of patients fail to recover from pain. This session will focus on a genome wide epigenetic screen that was performed to identify pre-surgical biomarkers that are predictive of 1-year postoperative recovery from pain following surgery for symptomatic lumbar spinal stenosis (LSS) due to spine facet osteoarthritis (S-FOA). 

At the end of this session, participants will be able to: 

• Learning Objective 1: Appreciate the burden of unfavourable outcomes in surgery for spine facet osteoarthritis.  

• Learning Objective 2: Understand the potential of biomarkers in blood to help predict potential successful candidates for spine surgery.  

• Learning Objective 3: Interpret the predictive value of an epigenetic polygenic risk score (E-PRS).

Equity, Diversity, and Inclusion in Canadian Arthritis Research: A Template Analysis of Researchers’ Perspectives and Experiences

Megan Thomas
14:30-14:45 EDT

Session Descriptor: Including underrepresented populations in arthritis research remains a challenge. Megan Thomas and team conducted a qualitative study to explore how researchers have used equity, diversity, and inclusion (EDI) in conducting research among people living with arthritis. Using template analysis, they identified barriers and facilitators for using an EDI lens in research, which will be presented in this session. 

At the end of this session, participants will be able to: 

• Learning Objective 1: Reflect on the importance of equity, diversity, and inclusion (EDI) to Canadian rheumatology research. 

• Learning Objective 2: Describe how EDI has been applied in Canadian rheumatology trials (RA, SLE, and JIA) to date. 

• Learning Objective 3: Identify barriers and facilitators for improving representation in Canadian rheumatology research. 

Microna-Sequencing in Liquid Biopsies from Individuals with Early Osteoarthritis and Early Rheumatoid Arthritis

Dr. Madhu Baghel
14:45-15:00 EDT

Session Descriptor: Dr. Baghel’s research addresses the challenges in early arthritis diagnosis, with focus on osteoarthritis (OA) and rheumatoid arthritis (RA), common but often diagnosed late. Using microRNA-sequencing, she seeks blood-based biomarkers (microRNAs) for distinct diagnosis of OA and RA in early stages. In this session, Dr. Baghel will discuss how the successful identification of such biomarkers could inspire simple blood tests in primary care, revolutionizing arthritis diagnosis.

At the end of this session, participants will be able to: 

• Learning Objective 1: Identify existing challenges in diagnosis of early osteoarthritis (OA) and early rheumatoid arthritis (RA). 

• Learning Objective 2: Describe the strength of microRNA-sequencing for biomarker discovery.

• Learning Objective 3: Recognize the potential of differentially expressed circulating microRNAs in distinguishing early OA and early RA versus healthy controls.

Health Break

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15:00-15:05 EDT

Panel Discussion

Moderators: Laurie Proulx and Anna Samson

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Patient Engagement in Arthritis Research

Panelists: Dr. Katie Birnie, Marcia Bruce, Dr. Elena Lopatina, Carley Ouellette, and Tracy Wasylak 
15:05-16:00 EDT

Session Descriptor: Alberta developed a pain strategy for the province in 2019.  The foundations behind the strategy were built off the voices of people with lived experience and patient oriented research findings. This session will focus on the Patient and Community Engagement Research work in Chronic Pain and the impact on driving improvements in Chronic Pain delivery across Alberta. 

At the end of this session, participants will be able to: 

• Learning Objective 1: Describe Alberta's approach to incorporating patients with lived experience into their pain strategy development and implementation. 

• Learning Objective 2: Describe the patient and community engagement research (PaCER) approach to understanding chronic pain. 

• Learning Objective 3: Identify approaches to implementing findings from the PaCER research work into practice. 

Networking Session

Moderators: Dr. Sian Bevan and Laurie Proulx

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Patient Engagement: A Deeper Diver Into the Future 

16:00 - 16:30 EDT

Housekeeping & Introduction to Keynote Sessions 

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Dr. Mohit Kapoor
11:30-11:40 EDT

Keynote Session 2

Moderator: Lucy Kovalova-Woods

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Living Well with Arthritis: Update on Treatment Options
 

Dr. Marie Hudson
11:40-12:10 EDT

Session Descriptor: This session will focus on recent progress in the area of therapeutic strategies in arthritis. In particular, Dr. Hudson will share some promising developments, as well as challenges, in the fields of rheumatoid arthritis and connective tissue diseases. 

At the end of this session, participants will be able to: 

• Learning Objective 1: Appraise novel mechanisms of action of medications to treat rheumatoid arthritis.

• Learning Objective 2:  Relate the emerging literature on CAR-T cells in the treatment of connective tissue diseases.

• Learning Objective 3: Identify challenges in conducting biomarker-driven clinical trials in rheumatic diseases.

Keynote Session 3

Moderator: Lucy Kovalova-Woods

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Patient Preferences in the Continuum of Evidence

Dr. Glen Hazelwood
12:10-12:40 EDT

Session Descriptor: This session will provide an introduction to patient preferences and demonstrate their critical importance in all aspects of drug decision-making, using applied examples.  

At the end of this session, participants will be able to: 

• Learning Objective 1: Understand what patient preferences are.

• Learning Objective 2: Understand the role of patient preferences in the evidence continuum, from regulatory decisions to individual patient choices. 

• Learning Objective 3: Understand why patient preferences are needed for personalized medicine.

Health Break

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12:40-12:45 EDT

Optimal Care

Moderator: Dr. Carter Thorne

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The Value of Rheumatology Care on Improving Health System Sustainability

Dr. Jessica Widdifield
12:45-13:00 EDT

Session Descriptor: This session will review findings from three published population-based studies that demonstrated that when rheumatology care is delayed, disrupted, or is less frequent, patients with rheumatoid arthritis are at greater risk for emergency department visits and hospitalizations and that these excess healthcare costs could be avoided by improving continuity of rheumatology care. Policy implications and future considerations to strengthen rheumatology workforce capacity in order to improve access and ongoing access to rheumatology care will be discussed.

At the end of this session, participants will be able to: 

• Learning Objective 1: Recognize the importance of early and ongoing outpatient rheumatology care on reducing costly acute care services (hospitalizations and emergency department visits). 

• Learning Objective 2: Describe threats to the sustainability of the rheumatology workforce that is impairing access to care.

• Learning Objective 3: Review the Canadian Rheumatology Association position statements for strengthening workforce capacity. 

Equitable, Person-Centered Osteoarthritis Care for Diverse Women

Dr. Anna Gagliardi
13:00-13:15 EDT

Session Descriptor: This session will provide an overview of a three-part study funded by Arthritis Society Canada that ultimately generated national inter-disciplinary consensus on strategies needed to optimize access to and quality of osteoarthritis care for diverse women, and possibly other equity-seeking groups. 

At the end of this session, participants will be able to: 

• Learning Objective 1: Understand the need for strategies to improve OA care for diverse women. 

• Learning Objective 2: Learn about the role of persons with lived experience in this research. 

• Learning Objective 3: Identify multi-level strategies to improve OA care generated by this research. ​

• Learning Objective 4: Consider how to implement the strategies considered highest priority. 

Engaging Young People in Rheumatology Care and Research: Challenges and Opportunities

Dr. Karine Toupin April and Naomi Abrahams
13:15-13:30 EDT

Session Descriptor: This session will provide information about shared decision-making and interventions used to facilitate this process in clinical practice, as well as their outcomes. It will provide examples from rheumatology literature and from the Choice Research Lab. The session will also describe how young people with lived experience can be engaged in research, as well as its challenges and opportunities. 

At the end of this session, participants will be able to: 

• Learning Objective 1: Describe shared decision making and interventions used to facilitate this process in clinical practice, as well as their outcomes.

• Learning Objective 2: Provide examples of shared decision making interventions for use in pediatric and adult rheumatology. 

• Learning Objective 3: Describe how young people with lived experience can be engaged in research, as well as its challenges and opportunities.

Panel: Ask Me Anything

13:30-13:45 EDT

Lunch Break

13:45-14:15 EDT

Best Research Presentations

Moderator: Dr. Sian Bevan

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Regenerative Approaches to Treat Disc Degeneration and Low Back Pain

Saber Ghazizadeh Darband
14:15-14:30 EDT

Session Descriptor: This session will outline the presenter’s recent study demonstrating the effectiveness of o-Vanillin and RG-7112 in alleviating symptoms of intervertebral disc degeneration and low back pain. With low back pain ranking as the leading cause of disability globally and no preventive treatments available, successful senolytic therapy could revolutionize care for millions. 

At the end of this session, participants will be able to: 

• Learning Objective 1: Understand the significance of low back pain in human health, including its prevalence, impact on quality of life, and economic burden on healthcare systems. 

• Learning Objective 2: Identify the cellular and molecular mechanisms associated with painful intervertebral disc (IVD) degeneration.

• Learning Objective 3: Evaluate the feasibility of using SPARC-null mice as a model to study the prevention or delay of painful disc degeneration through prophylactic treatment with senolytic drugs. 

• Learning Objective 4: Analyze the role of senescent cells in IVD degeneration, including their formation, impact on tissue homeostasis, and contribution to inflammatory environments. 

Elevated Serum Levels of S100A8/A9 Discriminate Systemic Lupus Erythematosus Patients with Cognitive Impairment from Patients without Impairment

Dr. Carolina Munoz Grajales 
14:30-14:45 EDT

Session Descriptor: This session will describe results suggesting S100A8/A9 role in cognitive impairment in the context of SLE.

At the end of this session, participants will be able to: 

• Learning Objective 1: Understand the definition of CI in SLE based on the ACR NB.

• Learning Objective 2: Recognize S100A8/A9 as a potential contributing factor in the development of CI in SLE.

• Learning Objective 3: Appraise a mechanistic model that can then be utilized to develop novel insights and treatment strategies for CI in SLE.

Oral Delivery of Delta-9-Tetrahydrocannabinol Provides Symptom and Disease Modification in Mouse Models of Knee Osteoarthritis

Anca Maglaviceanu 
14:45-15:00 EDT

Session Descriptor: This session will focus on the effects of THC on OA pain and disease progression in pre-clinical mouse models of OA using the Von Frey test and knee joint histopathological assessments. This session will also centre on the investigation of mechanisms responsible for the effects of THC in vivo using various methodologies, including functional assays, high-throughput bulk and single nuclei RNA sequencing, and metabolomics analyses on human and mouse biological samples.  

At the end of this session, participants will be able to: 

• Learning Objective 1: Determine pain and disease-modifying effects of THC in OA mouse models in vivo. 

• Learning Objective 2: Identify mechanisms of action of THC that may contribute to OA disease modification.

• Learning Objective 3: Identify cellular and molecular changes in the peripheral nervous system associated with the modification of pain by THC. 

The Influence of Pre-Surgery Factors on Pain and Disability Following Total Joint Arthoplasty for Osteoarthritis: A Sex-Specific Investigation

Dr. Anthony Perruccio
15:00-15:15 EDT

Session Descriptor: Differences in joint arthroplasty outcomes have been documented by sex, but there has been limited work taking a sex-specific approach to investigating predictors of outcome. Results from a study examining pre-surgery factors associated with pain and disability following TJA separately in males and females will be presented in this session, in addition to comparing findings when a sex-specific approach is not considered.

At the end of this session, participants will be able to: 

• Learning Objective 1: Reflect on the relative lack of sex-specific research on predictors of total joint arthroplasty (TJA) outcomes for hip and knee osteoarthritis (OA) patients. 

• Learning Objective 2: Recognize that failure to consider sex differences in TJA outcomes research may miss important contributors to outcome.

• Learning Objective 3: Compare factors associated with TJA outcome in male and female TJA patients.

Health Break

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15:15-15:20 EDT

Panel Discussion

Moderator: Dr. Clare Ardern

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Digital Health and Equity

Panelists: Alex Haagaard, Dr. Kendall Ho, and Dr. Jacob Jaremko 
15:20-16:00 EDT

Session Descriptor: This session will focus on essential digital health for the underserved, including how recent developments in handheld ultrasound and AI give the opportunity to screen babies for hip dysplasia, allowing effective treatment to prevent hip arthritis. Portable scanning by a simple protocol minimizing travel to tertiary care centres has potential to reach those at highest risk, especially First Nations people and those in remote/rural locations. 

At the end of this session, participants will be able to:

• Learning Objective 1: Identify major barriers and enablers to the use of digital health tools by underserved patient populations.

• Learning Objective 2: Understand major considerations for the equitable design and implementation of digital health tools.

• Learning Objective 3: Understand how clinical guidance, research and evaluation frameworks contribute to the perpetuation of digital health inequity.

• Learning Objective 4: Understand how digital accessibility must be incorporated into digital health design and implementation processes to achieve health equity.  

16:00 - 16:10 EDT:  

• Closing Remarks 

• Post-Conference Evaluation Survey Distribution Details 

Networking Session

Moderators: Dr. Mohit Kapoor and John Yan

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Trainees and Mentorship

16:10 - 16:40 EDT