In this episode, Dr. Proton Rahman reflects on his journey from patient with spondyloarthritis to internationally recognized rheumatologist and newly appointed member of the Order of Canada. He shares how his lived experience shapes his approach to patient care, offering insight into empathy, trust, and connection in chronic disease management.

Dr. Rahman also discusses the influence of key mentors — including Dr. Dafna Gladman, herself an Officer of the Order of Canada — in shaping his path into research and his work in the genetics of psoriatic arthritis and beyond! The conversation highlights the shift toward polygenic risk and the ongoing challenge of translating genetic discoveries into clinical practice.

Looking ahead, Dr. Rahman explores the future of rheumatology, emphasizing precision medicine, improved diagnostics, and more effective use of existing therapies. A thoughtful discussion on humility, mentorship, and the evolving complexity of modern rheumatology.

Dr. Proton Rahman is Clinical Chief of Rheumatology at Newfoundland and Labrador Health Services and John Lewis Distinguished Professor at Memorial University. A global expert in spondyloarthritis and psoriatic arthritis, his research focuses on the genetics of inflammatory arthritis and its translation into improved patient care. He is a recent appointee as a Member of the Order of Canada.

Around The Rheum is produced by the CRA Communications Committee. A special thank you to the podcast team, Dr. Dax G. Rumsey (CRA Communications Committee Chair), Dr. Daniel Ennis (Host), Dr. Janet Pope (Host) David McGuffin (exploreproductions.ca),

and Erin Stewart (CRA) for leading production.

Our theme music was composed by Aaron Fontwell.

For more on the work of the Canadian Rheumatology Association, visit rheum.ca

Hosts: Dr. Daniel Ennis, Dr. Janet Pope

Guests: Dr. Marinka Twilt (Pediatric Rheumatologist, University of Calgary; ASM Program Committee Chair), Dr. Mo Osman (University of Alberta; Abstract Chair & ASM Planning Committee Co-Chair)

We’re coming to you almost live from Halifax for Day 3—the final day of the Canadian Rheumatology Association ASM. The day featured strong podium presentations, a high-yield state-of-the-art lecture on Still’s disease, and a powerful closing keynote on health equity.

Podium sessions highlighted emerging science across the spectrum, including sex-based differences in psoriatic arthritis linked to genetic and epigenetic factors, novel monogenic variants in pediatric lupus with neurocognitive involvement, and ongoing inequities in access to therapies for JIA across provinces.

The state-of-the-art lecture on Still’s disease emphasized its spectrum across pediatric and adult care, with practical treatment strategies and increasing recognition of associated interstitial lung disease. Key points included the role of HLA-DRB1*15 as a risk marker, the importance of early treatment, and the potential for IL-1 and IL-6 therapies to contribute to complications in select patients.

Workshops reinforced these themes, focusing on practical approaches to diagnosing and managing Still’s disease, including lung involvement and the role of JAK inhibitors in refractory cases.

The meeting closed with a distinguished investigator lecture from Dr. Cheryl Barnabe, highlighting inequities in care for Indigenous populations and the importance of culturally safe, community-based care to address both geographic and systemic barriers.

Main Takeaways

• Genetic and epigenetic factors may explain sex differences in psoriatic arthritis
• Monogenic variants continue to reveal complexity in pediatric lupus
• Significant inequities persist in access to therapies for JIA across provinces
• Still’s disease spans pediatric and adult care with shared mechanisms
• HLA-DRB1*15 may help predict lung complications in Still’s disease
• Culturally safe, community-based care is essential to improving health equity

What’s Next

CRA ASM 2026 will be held in Vancouver.

More highlights coming next year—see you in Vancouver!

Hosts: Dr. Daniel Ennis, Dr. Janet Pope

Guests: Dr. Marinka Twilt (Pediatric Rheumatologist, University of Calgary; ASM Program Committee Chair), Dr. Mo Osman (University of Alberta; Abstract Chair & ASM Planning Committee Co-Chair)

We’re coming to you almost live from Halifax for Day 2 of the Canadian Rheumatology Association ASM. The day featured diverse podium science, practical workshops, and a lively Great Debate on DMARD tapering.

Podium sessions highlighted lupus research on cancer risk, rising costs and work disability in RA, and new biologic insights into flares, with B-cell changes supporting patient-reported disease activity in lupus.

Workshops focused on practical tools, including capillaroscopy for early CTD detection, pediatric updates on neonatal lupus risk (anti-Ro vs anti-La), and a structured lab-based approach to unexplained lymphadenopathy.

The Dunlop-Dottridge Lecture reviewed statin-associated myositis, emphasizing delayed onset, persistence after discontinuation of the statins, and early IVIG-based treatment.

The Great Debate explored DMARD tapering, reinforcing that while guidelines are cautious, real-world care requires shared decision-making and a focus on the lowest effective dose rather than full discontinuation.

Main Takeaways

Rising costs and ongoing work disability remain significant in RA

Patient-reported flares have a clear biological basis

Statin-associated myositis can occur years after statin use and requires early IVIG

DMARD tapering should be individualized, with focus on lowest effective dose

What to Watch for on Day 3

State-of-the-art lecture on Still’s disease across the lifespan

More high-impact podium presentations

Clinical workshops, including one on topical therapies

Gala dinner and closing events

More highlights coming tomorrow—stay tuned!

Hosts: Dr. Daniel Ennis, Dr. Janet Pope

Guest: Dr. Marinka Twilt (Pediatric Rheumatologist, University of Calgary; ASM Program Committee Chair)

We’re coming to you almost live from Halifax for Day 1 of the Canadian Rheumatology Association ASM. The day featured key updates across the field, including gaps in pediatric trials, growing recognition of autoinflammatory diseases, and the expanding role of genetics.

The SELECT-GCA trial reinforced that upadacitinib is effective for both induction and maintenance of Giant Cell Arteritis (GCA), with high relapse rates after stopping—supporting longer-term treatment. In pediatric ANCA vasculitis, rituximab showed similar efficacy to cyclophosphamide with a safer profile.

Sessions on “tough-to-treat RA” highlighted how often non-inflammatory factors drive symptoms, while Clinical Pearls and Medical Mysteries emphasized revisiting diagnoses and the importance of pathology and genetics.

The keynote by Dr. Elizabeth Volkman rounded out the day with a focus on holistic care and patient empowerment.

Main Takeaways

• GCA likely requires longer-term therapy to prevent relapse
• Rituximab is a safe, effective alternative in pediatric ANCA vasculitis
• “Tough-to-treat RA” often reflects non-inflammatory disease
• Reassess when treatments fail—diagnosis evolves
• Genetics and pathology are increasingly central to complex cases
• Holistic care and patient empowerment matter for outcomes

What to Watch on Day 2

• New myositis insights, including statin-associated disease
• Podium presentations showcasing emerging research
• Hands-on workshops (including TMJ)
• Poster tours, with a focus on trainee work
• The Great Debate: “Be it resolved that medications should be tapered in patients with inflammatory arthritis in remission.”

More highlights coming tomorrow—stay tuned!

Autoinflammatory diseases are often considered rare — but, in clinical practice, they may be far more common than we think. In this episode of Around the Rheum, hosts Dr. Daniel Ennis and Dr. Janet Pope speak with Dr. Jason An, a Toronto rheumatologist with expertise in autoinflammatory disorders.

Together, they explore how these conditions differ from classic autoimmune disease, why adult rheumatologists should be thinking about them more often, and how to approach diagnosis when the presentation doesn’t fit neatly into familiar categories.

Dr. An also shares practical strategies for recognizing autoinflammatory patterns, interpreting genetic testing, and using targeted therapies both diagnostically and therapeutically.

In this episode we discuss:

• The evolving definition of autoinflammatory disease and how it differs from autoimmune disease
• Why these disorders are not just pediatric diseases and may present in adulthood
• A practical cytokine-based framework for classifying autoinflammatory diseases
• The four major inflammatory “buckets”:
• IL-1–mediated diseases
• IL-18-mediated diseases
• TNF / NF-κB pathway disorders
• Interferonopathies
• Clinical pattern recognition in patients with recurrent fevers and systemic inflammation
• The role and limitations of genetic testing in autoinflammatory disease
• Why variants of uncertain significance (VUS) may still be clinically meaningful in adults
• Using targeted therapies as diagnostic tools (colchicine, IL-1 blockade, JAK inhibitors)
• When rheumatologists should consider referral to an autoinflammatory disease specialist

Recommended reading:

Dr. An’s review on autoinflammatory diseases in The Journal of Rheumatology:

https://www.jrheum.org/content/51/9/848

Dr. Jason An, MD, MSc is an adult rheumatologist specializing in the diagnosis and treatment of autoinflammatory diseases who works in community practice in the Greater Toronto Area (GTA)

Around The Rheum is produced by the CRA Communications Committee. A special thank you to the podcast team, Dr. Dax G. Rumsey (CRA Communications Committee Chair), Dr. Daniel Ennis (Host), Dr. Janet Pope (Host) David McGuffin (exploreproductions.ca), and Erin Stewart (CRA) for leading production.

Our theme music was composed by Aaron Fontwell.

For more on the work of the Canadian Rheumatology Association, visit rheum.ca