Ten Topics in Rheumatology meeting was held for the first time in our country. The meeting was organized by the Department of Rheumatology, Sir Ganga Ram Hospital, New Delhi, under the aegis of Ten Topics in Rheumatology, UK (Prof. Graham Hughes). This conference, organized over a period of 2 days, was a great success in terms of discussing the difficult and latest aspects regarding various rheumatic diseases.

The inaugural talk was given by Dr. A. N. Malaviya, who discussed the controversial topic regarding the guidelines for the treatment of rheumatoid arthritis given by ACR, EULAR, and IRA. He simplified this complex topic and gave clear messages about the pros and cons of each. The next talk was given by Dr. S. J. Gupta, who explained the art and need for tapering the treatment of rheumatoid arthritis. This was followed by the much-awaited discussion regarding the newer treatments that are in pipeline for the treatment of rheumatoid arthritis. Dr. Rohini Handa enumerated the modalities that will be available in the near future, especially the combination of anti-TNF and IL17 antibodies in a single drug. The first debate was a heated discussion, as expected, between the strong gathering of rheumatologists and a lone pulmonologist, who succumbed to the sheer numbers.

The next session was the symposium on connective tissue diseases, which began with the state-of-art lecture delivered by the master himself, Dr. C. C. Mok. Although the treatment of lupus nephritis is very challenging, the master explained and illustrated it very nicely. He explained the conventional treatments with mycophenolate and cyclophosphamide along with his own experience regarding the use of tacrolimus in lupus nephritis. Dr. Aman Sharma discussed the hot topic of management of pulmonary hypertension in a very innovative manner and helped us clear our queries in this topic.

Then came the inauguration time with the lamp lighting ceremony presided by the various dignitaries. The inauguration ceremony was a peaceful event, followed by a lively debate between Dr. P. D. Rath and Dr. Sapan Pandya regarding the treatment of ANCA-associated vasculitis, with the former favoring rituximab and the later favoring cyclophosphamide. The debate was a very “shayarana” affair, and Dr. Sapan Pandya could convince the moderator and the audience a fraction more than his rival. The post lunch session was the highlight of the day, with many top papers in both adult and pediatric rheumatology being discussed by Dr. Banwari Sharma and Dr. Amita Aggarwal. Dr. (Prof) Jim Rosenbaum elaborated the role of microbiome in rheumatic diseases. Gut microbiome is the topic that is the flavor of the day and the state-of-the-art lecture proved it so with various convincing studies, especially of the incidence and prevalence of rheumatic diseases in children born via vaginal delivery versus lower segment cesarian section (LSCS).

The highlight of the first day came in as Dr. Vinod Ravindran took over the proceedings. The audience was up in a flash with his warm-up deliveries of clinical cases and pictures. The matter further heated up with several difficult questions and complex answers, which were further simplified by Dr. Ravindran himself. Indeed, the voting meters felt the pain as the audience was fighting to grab the same! The last session of the day was the NIGHTMARE AT GANGA RAM STREET. As the name suggests, it was really a nightmare for the three consultants and their teams while managing these tough cases. Dr. Lalit Duggal discussed the case of a young girl who was a lupus treatment defaulter and had literally all the life-threatening bacterial, viral, and fungal infections. Her hospital course was a roller coaster ride.

Dr. Ved Chaturvedi presented a very interesting case of disseminated histoplasmosis, who presented with pyrexia of unknown origin (PUO), testicular mass, suprarenal mass, and arthritis. Dr. Sujata Sawhney discussed a challenging case of familial lupus and the difficulties in diagnosing and managing the rare diagnosis of cerebral venous sinus thrombosis in a young 7-year-old child whose mother is ANA positive and anti-Ro positive and grandmother had lupus.

After the successful completion of the first day, the second day began with Dr. Debashish Danda delivering a talk on psoriatic arthritis. The new treatments available, especially IL-17 and IL-12/23 inhibitors, the latest of which is a combination of anti-TNF and IL-17 inhibitors. The next session was a presentation regarding the treatment of ankylosing spondylitis. Dr. Ashok Kumar and Dr. Inderjeet Agarwal shared their immense experience on the use of anti-TNF drugs. They shed light on the important aspects, including the pros and cons, regarding the use of these drugs. Both the speakers agreed on the safety of etanercept being an edge over the rest.

The panel discussion saw the participation of Dr. Sanjeev Kapoor, Dr. Rahul Jain, and Dr. Sumeet Singla. This discussion covered various important aspects of rheumatology, including HIV-associated arthropathy, crystal arthropathy, and reactive arthritis. There was a complete participation from the audience in this discussion moderated by Dr B. D. Pandey. Pot pouri is an integral component of Ten Topics meeting. It included three important topics of laboratory tests and its implication in clinical practice by Dr R. N. Mishra, role of nail fold capillaroscopy in various rheumatic diseases by Dr. Vivek Vasudev, and the role of MSK ultrasound by Dr. Raghav Agarwal. The last session of the meeting was a symposium on APLA, which has two important clinical implications with regards to thrombosis and pregnancy morbidity. The role of APLA in pregnancy was discussed by Dr. C. C. Mok, who enlightened us with his experience in dealing with asymptomatic APL carriers and those with recurrent abortions. Dr. Rajiva Gupta shed light on the most difficult part of APLA, which is beyond thrombosis and miscarriage. The meeting was concluded by last talk delivered by Dr. Sumeet Agarwal regarding the role of new anticoagulants in APLA.

Management of uveitis requires co-management by rheumatologists. For the first time, a uvea rheumatology interface meeting was organized. Dr. James Rosenbaum, professor of rheumatology and ophthalmology from Portland, United States, graced the occasion. He presented his experience with a talk on Rheumatologist’s Approach to Uveitis. He also chaired a session where cases were jointly presented by ophthalmologists and rheumatologists, highlighting the team work required for managing these cases. This meeting was the first endeavor to bring both ophthalmologists and rheumatologists to a common platform. The meeting was coordinated by Dr. Amit Khosla from the Department of Ophthalmology, Sir Ganga Ram Hospital. A session was organized on immunosuppressives, which helped clear doubts among ophthalmologists on their use. This session was organized in association with the UVEITIS Society of India. About 15 uvea faculties participated in the deliberations. Ten Topics meeting was attended by approximately 275 delegates.