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Inside ACR Convergence 2024: Day 4 Highlights

That’s a wrap. Here are highlights from Day 4 of ACR Convergence 2024 and our last update on the latest research, advancements, and breakthroughs in arthritis.

Experts Debate Medical vs. Lifestyle Interventions for Obesity and Osteoarthritis

Obesity is a major contributor to the development and progression of osteoarthritis (OA). During the session Weighing In: A Debate on Medical vs. Behavioral Lifestyle Interventions for People with Obesity and Osteoarthritis at ACR Convergence 2024, experts discussed the benefits and challenges of medical treatments and lifestyle interventions for weight management in patients with OA.

Stephen Messier, PhD, Professor and Director of the J.B. Snow Biomechanics Laboratory at Wake Forest University, championed diet and exercise as the optimal approach to stimulate weight loss for people living with obesity and OA. He presented research showing that combined weight loss and exercise reduced knee OA pain by 51% over 18 months—twice the reduction achieved by either intervention alone. Dr. Messier highlighted the long-term cost-effectiveness and sustainability of lifestyle interventions, advocating for community-based programs supported by healthcare insurers.

In contrast, Martin Englund, MD, PhD, Professor at Lund University, supported glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide (Ozempic), citing their ability to produce 10-15% greater weight loss compared to lifestyle changes. He presented studies showing GLP-1 drugs also improve OA pain and function. While acknowledging the high costs and potential for weight regain without continued use, Dr. Englund argued that lifelong treatment is common for chronic diseases and can be cost-effective as drug prices decline.

Both experts agreed on the foundational importance of lifestyle changes, with Dr. Englund noting that medical treatments should complement—not replace—behavioral strategies for a sustained, healthy life.

Dive Deeper

ACE interviews Dr. Derin Karacabeyli, rheumatology resident at the University of British Columbia in a recent Arthritis at Home episode where he shares the work he is conducting to look at the potential risks and benefits for inflammatory arthritis patients taking (GLP-1) receptor agonists medications. 

To learn more about the benefits of exercise and arthritis, take the ACE’s JointHealth Education Course on Arthritis and Exercise.

Lecture examines psychological impacts of living with arthritis 

Living with arthritis impacts not only physical health but also mental health, as highlighted by Afton Hassett, PhD, associate professor in the Department of Anesthesiology at the University of Michigan, during the lecture – Navigating the Unseen — Fostering Mental Health in Rheumatic Disease

According to Dr. Hassett, approximately 20% of the U.S. population lives with chronic pain (paint that persists for three months or longer), which often leads to mental health challenges such as depression, anxiety, and loneliness, which can worsen disease outcomes.

Dr. Hassett emphasized building resilience as a key strategy to improve psychological and physical health. She characterized pain resilience as a teachable trait or life skill that encompasses psychological, social, and biological factors alongside healthy lifestyle habits. She shared studies that showed optimistic patients report less pain and better outcomes, while those experiencing loneliness or depression face increased disease activity and poorer health.

Dr. Hassett outlined practical strategies, including positive activity interventions (PAIs), to foster resilience. Examples include scheduling enjoyable activities, keeping gratitude diaries, and performing acts of kindness. These non-stigmatizing and cost-effective approaches encourage emotional well-being without the barriers often associated with traditional mental health treatments.

For both patients and healthcare professionals, incorporating resilience-building techniques can lead to better adaptation to pain, improved quality of life, and reduced burnout. “Finding joy, connection, and purpose is critical for navigating the unseen challenges of living with and treating chronic diseases,” Dr. Hassett concluded.

Dive Deeper

People with arthritis are more at risk for developing mental health issues because of the interaction of anxiety, depression, and fatigue with chronic arthritis pain. Arthritis Research Canada reports up to 70% of patients with rheumatoid arthritis experience anxiety and up to 38% experience depression; up to 40% of lupus patients experience anxiety and 30% experience depression.

Arthritis Consumer Experts (ACE) conducted a National Survey on Arthritis and Mental Health to understand what steps people living with arthritis take to take care of their mental health and what specific challenges they may face when accessing timely professional care. The survey findings also help us understand how patient organizations, health care providers and the healthcare system can better support people living with arthritis with their mental health and overall wellbeing.

To view an Arthritis at Home episode looking at the results of this National Survey, click here.

ACR launches campaign to promote self-management for people with arthritis

The American College of Rheumatology (ACR) has introduced a new patient education campaign, Self-Management for Patients Living with Rheumatic Conditions. This initiative emphasizes the importance of self-management strategies in improving quality of life for people with arthritis, addressing gaps in awareness and motivation. The campaign addresses the current knowledge gap, educates patients about self-management techniques, and encourages people with arthritis to collaborate actively with their arthritis healthcare team to manage their arthritis.

“One thing that is important to note is that self-management is often used interchangeably with self-care, but they are different. Self-management is an individual’s day-to-day management of their chronic conditions over the course of an illness,” says Bhakti Shah, MD, a rheumatologist with Crystal Run Healthcare in Middletown, NY, and the campaign’s medical spokesperson. “Self-care consists of those tasks performed by healthy people to prevent illness rather than manage an existing illness.”

The campaign encourages patients to partner with their healthcare team and adopt five key strategies:

  1. Stress Management – Incorporate relaxation techniques like meditation, journaling, or mindfulness to support mental and physical health.
  2. Medication Adherence – Work closely with healthcare providers to understand and follow prescribed treatments.
  3. Lifestyle Changes – Maintain regular exercise and a balanced diet to promote overall well-being and reduce symptoms.
  4. Communicate with Healthcare Teams – Foster open communication with rheumatologists, therapists, and specialists to create personalized care plans.
  5. Build a Support System – Seek help from family and friends, especially during flares.

“We hope this campaign empowers patients to take an active role in their care,” Dr. Shah said, emphasizing collaboration between patients and providers to achieve better outcomes. 

Dive Deeper

Self-management is the ability to manage symptoms and treatments related to living with a chronic disease such as rheumatoid arthritis. It includes some of the following:

  • Balancing activities such as sleeping, resting, and being physically active,
  • Knowing when it is time to seek help from a healthcare provider, and
  • Practicing self-care.

Arthritis Consumer Experts was a patient partner in a study led by Dr. Linda Li, Senior Scientist, Implementation Science at Arthritis Research Canada that looked at whether an online self-management tool could improve active self-management among people living with rheumatoid arthritis. This included remote counselling from a physiotherapist and the use of a digital app.

The study found that counselling paired with self-monitoring tools improved self-management ability in people with RA and helped with disease activity, fatigue, and depression.

This research is important because it shows that providing people with rheumatoid arthritis access to physiotherapist counselling paired with self-monitoring tools, like an online app and wearable activity tracking device, can help them to better manage their arthritis and to be more active. 

If you are living with RA, consider speaking with your health professional about trying a program that includes physiotherapy counselling and a wearable device.