Top Conversations from RWCS 2026

The 2026 Rheumatology Winter Clinical Symposium, held February 11–14 at the Wailea Marriott in Maui, Hawaii, brought together leading clinicians and researchers for the meeting's 19th annual installment. As one of rheumatology's premier forums, RWCS is structured around year-in-review sessions, evidence-based presentations, and case-driven discussions designed to translate emerging research into practical clinical guidance. RheumatologyLive was on the ground throughout the meeting, sitting down with faculty and participants across a range of topics—from the nuts and bolts of outcome measure selection and the evolving role of AI in day-to-day practice, to the rapidly shifting therapeutic landscape in large vessel vasculitis, the persistent challenges of difficult-to-treat spondyloarthritis, and a renewed focus on closing the longstanding treatment gap in osteoporosis.

In this article, our editorial team has curated 5 of these impactful conversations, highlighting key updates and trends showcased at the meeting that clinicians should know.

1. Integrating AI Into Everyday Rheumatology Practice — Alvin Wells, MD, PhD, and Orrin Troum, MD

Alvin Wells, MD, PhD, director of the rheumatology department at American Medical Group in Destin, Florida, and adjunct assistant professor at Duke University Medical Center, and Orrin Troum, MD, clinical professor of medicine and chief of rheumatology at Providence Healthcare System in Santa Monica, California, emphasized that AI's growth in healthcare has been evolutionary rather than abrupt, with telehealth and virtual care already normalizing remote interaction well before the pandemic accelerated the shift. The most tangible near-term impact, they noted, lies in administrative applications—AI-powered scribes that allow clinicians to maintain eye contact with patients while the encounter is documented, alongside tools that draft letters of medical necessity and automate routine communications. Both experts framed these workflow gains as a foundation for broader integration, while underscoring that the physician must remain the final decision-maker as AI's clinical role continues to develop.

2. From Clinical Trials to Clinic: Making Sense of Rheumatology Metrics — Roy Fleischmann, MD

Roy Fleischmann, MD, professor of medicine at the University of Texas Southwestern Medical Center in Dallas, used his talk at RWCS 2026 to address persistent confusion about which outcome measures belong in clinical trials versus which are genuinely useful at the bedside, noting that the 2 purposes are not interchangeable and that misapplication remains common among both clinicians and industry. For rheumatoid arthritis (RA), he pointed to CDAI, SDAI, and Boolean remission criteria as the most practice-applicable tools, cautioning that instruments like RAPID3 lack the specificity needed to reliably track disease state or detect meaningful clinical change. Across psoriatic arthritis (PsA), lupus, and axial disease, he consistently distinguished between measures designed for research populations and those that can realistically inform treatment decisions in a standard clinic visit.

4. Difficult-to-Treat Disease in PsA and axSpA: Lessons from 2025 — Eric Ruderman, MD

Eric Ruderman, MD, professor at the Feinberg School of Medicine at Northwestern University, characterized 2025 as a year of strategic consolidation rather than headline approvals in PsA and axSpA, with the field shifting toward questions of therapy durability, persistence on treatment, and the practical realities of managing heterogeneous patient populations. He highlighted emerging data on biologic continuation rates in axSpA, insights into why patients discontinue therapy—including the observation that women and patients with non-radiographic disease show distinct persistence patterns—and early signals around dose optimization strategies with established agents. The through line of his discussion was where unmet need remains most acute: patients with difficult-to-treat disease who fail multiple mechanisms and lack validated biomarkers to guide next steps.

4. Improving Diagnostic Precision and Long-Term Control in Large Vessel Vasculitis — Anisha Dua, MD, MPH

Anisha Dua, MD, MPH, professor at Northwestern University Feinberg School of Medicine and director of the Vasculitis Center, described vasculitis as having entered a markedly different era, with rapidly expanding treatment options—particularly across giant cell arteritis (GCA), Takayasu arteritis, and PMR—reshaping both physician confidence and the ability to prevent irreversible organ damage rather than simply controlling inflammation. She noted that earlier recognition and a growing therapeutic armamentarium have meaningfully changed the clinical picture for patients who historically faced delayed diagnosis, limited options, and sparse peer support given the rarity of their conditions. Dua also pointed to the continued importance of patient advocacy organizations and ongoing research into biomarkers and disease subclassification as essential complements to the therapeutic progress already underway.

5. Optimizing Osteoporosis Prevention and Therapy Selection — Gina Woods, MD

Gina Woods, MD, clinical professor of medicine and director of the Osteoporosis and Preventive Bone Health Programs at the University of California San Diego, stressed that osteoporosis is in many cases preventable, and that 3 FDA-approved classes—hormone therapy, SERMs, and bisphosphonates—remain underutilized for prevention despite their established efficacy, with renewed interest in menopause hormone therapy offering a potential opening to close that gap. She framed therapy selection and sequencing as a long-game strategy, noting that the order in which treatments are used directly affects their efficacy and that clinicians must plan ahead given the time-limited nature of most agents and the rare but serious risks associated with some. Beyond pharmacology, Woods called for greater investment in healthcare delivery science, arguing that understanding barriers to treatment initiation and adherence may yield as much clinical impact as the discovery of new drugs.