How the Arthritis Foundation is Advancing Research
The statistics are chilling: An estimated 50 million adults in the U.S. suffer from the more than 100 different rheumatic diseases that comprise arthritis, most commonly osteoarthritis (OA), a chronic joint disease of the hands, hips, knees and spine, and rheumatoid arthritis (RA), an autoimmune disease affecting the joints. An additional 300,000 children under the age of 16 are afflicted with juvenile arthritis (JA), which causes persistent joint pain and can result in growth problems and eye inflammation.
Arthritis Foundation-funded research in 2009 helped establish a new diagnostic test for a rare form of juvenile arthritis
Since its inception in 1948, it has been the goal of the Arthritis Foundation to help educate arthritis patients about their disease and to fund research to determine the underlying causes of arthritis and find more effective treatment and eventually a cure. During that time, the Foundation has funded the work of more than 2,600 scientists, many of whom remain in the field today.
Since 1948, the Arthritis Foundation has contributed more than $450 million to arthritis research, an investment that has contributed to the staggering progress in developing new diagnostic tests, such as the anti-cyclic citrullinated peptide antibody test (anti-CCP), a blood test that helps confirm a diagnosis of rheumatoid arthritis and may be a predictor in determining which patients may be at greater risk for contracting a more severe case of RA, and the discovery of new therapeutics, including biologic agents approved in the late 1990s in the treatment of arthritis.
“The use of biologics has really transformed the lives of people with rheumatoid arthritis, psoriatic arthritis and juvenile arthritis,” says John Hardin, MD, chief scientific officer of the Arthritis Foundation. “I don’t think we can say that it was any one grant from the Arthritis Foundation that made a contribution to those drug discoveries. That contribution was based on a large number of insights that go back to the 1950s and then drew on technology from other sources. But it is fair to say that the Arthritis Foundation contributed at multiple levels along the way.”
Some of the results from those contributions include:
• Tests to identify patients with a more severe course of the disease
• Blood tests to monitor potential drug side effects
• Better diagnostic tools, including a more accurate test for a rare for of juvenile arthritis
• A better understanding of the genetics involved in the development of RA and JA
• The discovery of a previously unknown mechanism that promotes inflammation in the joints of patients with RA
Future Goals
"One goal of the Arthritis Foundation is to develop drugs that more effectively stop the progression of RA and not just improve the symptoms of induce a substantial remission,” says Dr. Hardin. “We want drugs that actually stop the disease in its tracks and make it go away. A second goal is to have the ability to detect people who are at risk for developing RA and have the means to prevent them from developing the disease. If we could achieve those two things, I think we could say that RA has been conquered.”
Dr. Hardin predicts that those goals can be achieved over the next five years. “We’re beginning to get clarity on who’s at risk for developing RA through our genetic studies,” says Dr. Hardin. “And we’re closing in on a date of when we will be able to do a genetic analysis and identify people who are most vulnerable for getting the disease. It’s probably in the three-to-five-year timeframe. And, we will be testing some drugs that theoretically safely intervene and prevent people from getting RA. For example, it’s a reasonable hypothesis that patients with a certain genetic profile can be identified and potentially treated prophylacticly with a drug called plaquenil (hydroxychloroquine) as a preventive treatment for RA.”
Eliminating Joint Deterioration in Osteoarthritis
Osteoarthritis, sometimes referred to as degenerative joint disease or osteoarthrosis, is the most common form of arthritis and is caused by the breakdown of cartilage in the joints. It usually affects adults age 55 and older. And while physical therapy and medications may help in controlling the pain of OA, when the joints become nonfunctional, the only current alternative is surgery to replace the damaged joint.
“We’re pretty good at replacing joints as they become completely nonfunctional, but that’s far from a satisfactory solution,” says Dr. Hardin. “We want to have the ability to prevent joint deterioration from occurring and the question is how do we get there? And research in the field has made enormous strides forward in understanding the biology of the joint, cartilage and the other tissues that make up the joint.”
One area of research the arthritis is funding that may help OA sufferers frin relief before they become symptomatic and their joints deteriorate to the point of needing replacement is identifying biomarkers for OA that can help predict which patients would respond to a specific treatment.
Being able to predict which drugs would be most effective in the treatment of children with juvenile arthritis is at the forefront of Foundation-funded research as well.“Where we want to be in the future, is to have the ability to prevent the disease from occurring and if it does, to stop it,” says Dr. Hardin. “The Arthritis Foundation is not just a passive player in trying to reach these goals. We’re proactively trying to ensure that specific achievements take place. “
