Scientific Program Highlights

CORA will have a Keynote Lecture, Debate Sessions, Curbsite Consultations, Scientific Sessions, Oral Presentations​​​, Posters and more. Explore introductions by the speakers to their sessions below, or for the CORA 2017 timetable, please click here​.


Keynote Lecture

​Is the microbiome the key for autoimmunity?​

by Yehuda Shoenfeld

All factors involved in inducing, accelerating and inhibiting autoimmunity were found to affect the bacterial populations in the gut: the microbiome. These factors include smoking, obesity, vitamin D, salt, spicy food, curcumin and the presence of helminthes and their products.


​​​Major Debates

Can we withdraw anticoagulation in patients with APS after seroreversion? 

  • Ricard Cervera - Yes We Can
    Although patients with APS are at increased risk for recurrent thrombosis and benefit from long-term anticoagulation, lifelong oral anticoagulation is associated with increased risk of serious bleeding. Therefore, efforts to disclose any subset of thrombotic APS patients who can benefit from anticoagulation withdraw are of paramount importance.
    - I will critically analyze the published cases.
    - I will propose, from the previous analysis, some specific situations where anticoagulation withdraw could be an acceptable option.
    Relevant Article - Click here
  • Maria Cuadrado - No We Can't
    The question does not currently has a clear answer, so this debate will help doctors to take decisions in their daily clinical practice. 
    - I will present the arguments for maintaining anticoagulant treatment even if the antiphospholipid antibodies became negative.

Do we need to supplement vitamin D in autoimmune rheumatic diseases? – The rematch

  • Yehuda Shoenfeld - Yes We Do
    This issue is a novel aspect of therapy in autoimmunity. I will present:
    - Vitamin deficiency is instrumental in the pathogenesis of ALE as in other autoimmune diseases.
    - Vitamin supplementation is important as an additional adjunct for therapy.
    Relevant Article (link): Vitamin D and Systemic Lupus Erythematosus: Myth or Reality? Watad A, Neumann SG, Soriano A, Amital H, Shoenfeld Y., Isr Med Assoc J. 2016 Mar-Apr;18(3-4):177-82. Review.
    Relevant Article (link): 
    Vitamin D in systemic and organ-specific autoimmune diseases. Agmon-Levin N, Theodor E, Segal RM, Shoenfeld Y., Clin Rev Allergy Immunol. 2013 Oct;45(2):256-66. doi: 10.1007/s12016-012-8342-y. Review.
    Relevant Article (link): 
    Eppur Si Muove: vitamin D is essential in preventing and modulating SLE., Azrielant S, Shoenfeld Y., Lupus. 2016 May;25(6):563-72. doi: 10.1177/0961203316629001. Review.
  • Ian Bruce - No We Do Not
    To help understand the difference between association and causation in epidemiology and therapeutics. By the end you will:
    - Understand the potential links between vitamin D and autoimmunity
    - Understand the levels of evidence required to recommend widespread interventions.
    Relevant Article (link): Vitamin D for connective tissue diseases: hope beyond the hype? Reynolds JA, Bruce IN. Rheumatology 2017;56:178-186.

Are 2010 diagnostic criteria for fibromyalgia better than ​​​1990? 

  • Ernest Choy - 2010 are Better
    Fibromyalgia is a major healthcare burden. Enabling general practitioners to diagnose and manage fibromyalgia in primary care is important. However, Rheumatologists need to GP with the right tools to diagnose and manage these patients.
  • D. Buskila - 1990 are Better

Targeting BAFF/BLyS in SLE: is the glass half-full or half-empty? 

  • Matthias Schneider - Half Empty
    For the long-term outcome in SLE:
    - Learn to integrate the various targets in SLE into one strategy
    - Understand the risk of glucocorticoids for long-term outcome
  • Andrea Doria - Half Full

Should we treat asymptomatic hyperuricemia?

  • Claudio Borghi - Yes We Should
    - To describe the epidemiology and clinical impact of symptomatic hyperuricemia
    - To suggest how and why to manage it in clinical practice
  • T. Bardin - No We Shouldn't

Can we withdraw immunosuppressants in patients with lupus nephritis in remission?​

  • Dimitrios Boumpas - No We Can't
    Discontinuation of immunosuppression is a disarable target for physicians and patients alike since therapy may have side effects. The question is can this be done safely for which patients and how. I will:
    1. Define ''true'' form ''pseudoremission''.
    2. Recognize in clinical practice the few patients that can discontinoue immunosuppression. 
    3. Provide a practical method for the early recognittion of flare.
  • G. Moroni - Yes We Can

Is ACPA positivity the main driver in RA treatment?

  • F. Ferraccioli - Yes It Is
  • Yaakov Naparstek - No It Isn't
    The concept that the identification of ACPA as a specific autoantibody for RA has led to much better understanding of the pathogenesis of the disease, to the "death of RF", and to a better biomarker for the treatment of the disease becoming very popular. 
    I believe we should still look at it with a critical eye: Although ACPA have a role in the diagnosis of RA, their role in the pathogenesis of the disease and their role in assisting the clinician in choosing the appropriate therapeutic approach in the treatment of RA is minimal.

Is undifferentiated Spondyloarthritis a discrete entity?

  • Atul Deodhar - Yes It Is
    With huge strides being made in pathophysiology, classification and management, this debate on Peripheral spondyloarthritis will be lively, entertaining yet educational.
    While axial spondyloarthritis grabs all the attention in the rheumatology world today, peripheral spondyloarthritis is arguably more common, but often a missed and neglected condition. This session will cover how to recognize, diagnose and treat this entity.
    Relevant Article - Click here
  • X. Baraliakos - No It Isn't

TNF inhibitors in RA and SpA: are they all the same?

Can we manage lupus nephritis without chronic corticosteroids administration?


​Short Debates

Biosimilar vs Innovators: are they identical?​​

  • Zoltan Szekanecz - They Are Different
    Biosimilars are cheaper but there are numerous issues with regards to their use, which needs to be discussed.
    - I will differentiate between original and biosimilar targeted therapies.
    - And acknowledge major similarities and differences.
  • R. Caporali - They Are Identical

​Should we treat congenital heart block with fluorinated corticosteroids?

  • Antonio Brucato - Yes
    The management of pregnant women that are anti-Ro/SSA positive is challenging: Whether to use or not to use fluorinated corticosteroids in fetus with congenital heart block is a difficult decision.
  • N. Costedoat Chalumeau - No

Should we prescribe aspirin to asymptomatic APS?

  • Laurent Arnaud - Yes
    Strategies for assessing the benefit/risk ratio of aspirin for primary prophylaxis of thrombosis in patients with autoimmune diseases and aPL antibodies will be reviewed in-depth:
    - Assess the risk of thrombosis associated with aPL
    - Identify the predictors of thrombosis in patients with aPL
    - Understand the benefit of aspirin in patients with aPL
    Article link - click here
  • V. Pengo - No

PET-CT is essential in the diagnosis and follow-up of temporal arteritis​

Targeting IL-17 in RA and SpA. Is it equally effective?​​

Hyaluronic acid in osteoarthritis​

Tofaticinib is effective and safe in RA pa​tients​


Curbside Consults

Difficult clinical cases discussed by top experts

  • Systemic sclerosis
    Animator: M. Matucci Cerinic, Italy
    Discussants: G. Riemekasten, Germany; A. Gabrielli, Italy

  • ​Rheumatoid arthritis​
    Animator: PC Sarzi-Puttini, Italy
    Discussants: GF Ferraccioli, Italy; M. Schneider, Germany; A. Rubbert-Roth, Germany

  • Antiphospholipid antibody syndrome 
    Animator: A. Tincani, Italy
    Discussants: R. Cervera, Spain; PL Meroni, Italy; M. Tektonidou, Greece

  • ​Psoriatic arthritis​
    Animator: A Marchesoni, Italy
    Discussants: X Baraliakos, Germany; I. Bruce, UK


​​Scientific Sessions

Non organ-specific autoimmune diseases​​

  • Alessandro Antonelli - Thyroid Autoimmunity
    Autoimmune thyroid diseases (AITD) are present with a high prevalence in the general population (it is estimated to be >10%).  AITD can lead to thyroid dysfunctions (hypo-, or hyper-thyroidism), and they are associated with a higher prevalence of thyroid nodules and cancer. Moreover, associations exist between AITD and other organ specific, or systemic autoimmune disorders, in about 20% of AITD patients.
    Participants will understand:
    - AITD are T-cell-mediated organ-specific autoimmune disorders leading to an immune attack to thyroid.
    - Data that suggests AITD patients should be monitored and treated for thyroid dysfunctions and/or nodules, and those developing new not specific symptoms should be screened for other autoimmune disorders.
  • Annegret Kuhn - Autoimmune Dermatoses
    Due to growing insights into the pathogenesis of autoimmune diseases of the skin at the cellular and molecular levels, novel targeted treatment options are under development. The lecture will give an update on the currently available therapeutic strategies for skin manifestations of lupus erythematosus, systemic scleroderma, and dermatomyositis, and summarize the most important aspects on new agents.  
    (The treatment options in these autoimmune diseases are based on expert opinions, case reports, small case series, open-label trials, retrospective analyses and only single randomized controlled trials.)
    - Article link - click here
  • Aaron Lerner - Celiac disease: Anti-gliadin anti-TG or anti-TG novel epitope?

New aspects in the treatment of au​toimmune diseases 

  • Howard Amital - Cannabis in autoimmune diseases: a new horizon in treatment?
    The topic is pertinent for the rheumatologist trying to offer therapeutic options for patients with rheumatic/autoimmune disorders.
    1. I will explore the fundamental behind medical use of Cannabis
    2. I will present the unmet needs in rheumatic conditions that cannabis may solve
  • G Riemekasten - Immunosuppression in Systemic sclerosis: are we too lenient? 
  • BF. Hoyer - Targeting long-lived plasmacells in SLE

News from the laboratory

  • Anna Ghirardello - Recent advances in myositis antibody testing 
    Accurate diagnostics in autoimmunity is increasing in relevance. I will cover:
    - New advances in myositis autoantibody testing.
    - Update of new autoantibodies as biomarkers of autoimmune myositis.
  • Nicola Bizzaro - DFS70 a new diagnostic or prognostic marker
    - Discuss current controversies on the significance of DFS70 antibodies.
    - Provide the state of art on the clinical association, pathophysiological significance and diagnostic methods for their proper detection.
    - Relevant Article (link): Recognition of the dense fine speckled (DFS) pattern remains challenging: results from an international internet-based survey. Bentow C, Fritzler MJ, Mummert E, Mahler M. Auto Immun Highlights. 2016 Dec;7(1):8. doi: 10.1007/s13317-016-0081-2. For the article, click here
    - Relevant Article (link): Measurement of anti-DFS70 antibodies in patients with ANA-associated autoimmune rheumatic diseases suspicion is cost-effective. Gundín S, Irure-Ventura J, Asensio E, Ramos D, Mahler M, Martínez-Taboada V, López-Hoyos M. Auto Immun Highlights. 2016 Dec;7(1):10. doi: 10.1007/s13317-016-0082-1.
  • C. Edwards - New antiphospholipid antibody testing
  • L. Czirjak - Clinical role of new scleroderma autoantibodies

Vasculitis 

  • Luca Quartuccio - Cryoglobulinemia: is it still a problem?
    The role of possible infections (HCV in particular) and possible mechanisms of resistance to B cell depleting therapies are crucial to better address the treatment of this vasculitis.
    - New treatments for HCV with direct viral agents (DAA) are very effective in virus eradication. Is the same for HCV-related cryoglobulinemic vasculitis?
    - What do we learn about cryoglobulinemia from these new treatments for HCV? Is it an infectious disease or an autoimmune disease?
    - And how can we manage cryoglobulinemic vasculitis in the context of systemic connective tissue diseases, such as Sjogren's syndrome?
  • Raashid Luqmani - Controversy in treatment of ANCA-associated vasculitis
    The pathogenesis of ANCA vasculitides is becoming better understood and leading to major changes in our therapeutic approach in the next few years, especially in use of biological agents.  The greatest challenge is now the co-morbidity and damage from disease and its treatment. By the end, participants will:
    - Understand the variety of clinical presentations and outcomes in ANCA associated vasculitis.
    - Think about and understand the therapeutic approach, which should be mechanism based but also directed according to need and response in the clinical features of disease.

Co-morbidity and multimorbidity in ARD

  • Pierantonio Ostuni - Multimorbidity: the real challenge in ARD
    Owing the increasing prevalence of multimorbidity, clinical but also health economic implications have become more prominent, and can heavily impact therapeutic decisions. I will cover:
    - The paradigm of “1 patient -1 disease” no longer fits the medical necessities and needs of most patients, and expecially those affected by multisystemic diseases like ARDs. That is particularly significant in the aging population.  
    - Evidence-based guidelines for clinical practices for treating multiple chronic conditions in patients with ARDs.
  • Roberto Gerli - Atherosclerosis in ARD: the missing link
    Chronic inflammatory autoimmune rheumatic diseases are characterized by increased mortality with respect to the general population. The main cause is represented by cardiovascular complications. This is due to an acceleration of atherosclerotic processes with consequent precocious damage of arterial wall.
    The link between chronic inflammation and atherosclerotic damage of arterial wall has been only in part clarified until now. Recent findings in this research field may contribute to an improvement not only from a pathogenic point of view, but also to an improvement in the treatment of these disorders.
    - Relevant Article (link): Bartoloni E et al. Central Hemodynamics and Arterial Stiffness in Systemic Sclerosis. Hypertension 2016;68:1504-1511
  • F. Atzeni - Infections and Biologics: the Rheumatologist’s threat

​Pregnancy in autoimmune rheumatic diseases​

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