ARCHIVED - Health Research - Investing in Canada's Future 2003-2004

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Arthritis

The Canadian Institutes of Health Research (CIHR) is the Government of Canada’s premier agency for health research.

Through CIHR, the Government of Canada has invested more than $43 million in research on arthritis and musculoskeletal diseases across Canada.

The Facts

• Arthritis consists of more than 100 different conditions, including lupus, fibromyalgia, gout and scleroderma.
• The most common type of arthritis in Canada is osteoarthritis, affecting 3 million Canadians, or one in every 10. Long-term disability accounted for almost 80% of the economic costs of arthritis in 1998, at nearly $3.5 billion, the 35-64 year age group incurred 70% of these costs.
• Rheumatoid arthritis is the second most common type of arthritis, affecting 300,000 Canadians, or 1 in 100. It is an auto-immune disorder, in which the immune system attacks healthy joints, resulting in damage to cartilage, bone, tendons and ligaments. Twice as many women as men get rheumatoid arthritis. It most commonly appears between the ages of 25 and 50.
• Two-thirds of those with arthritis are women and nearly 60% are under the age of 65.
• Chronic pain and reduced mobility and function are the most common outcomes of long-term arthritis.
• For all age groups, arthritis disables two to three times more workers than all other chronic conditions.
• Epidemiologists predict there will be about 100,000 new cases of arthritis each year for the next 30 years. It is estimated that by 2026, more than 6 million Canadians over the age of 15 will have arthritis.
• Musculoskeletal diseases (arthritis and osteoporosis) cost Canadians $16.4 billion every year, the second highest cost of disease after heart disease. Of this total, $2.6 billion is in direct costs, such as physician and hospital care and drugs, and $13.7 billion is in indirect costs, including premature disability and death.
• The economic burden of all musculoskeletal conditions in Canada accounted for 10.3% of the total economic burden of all illnesses, but only 1.3% of health science research.

Research

Improving Health

• Physicians can now diagnose osteoarthritis of the knee at an earlier stage, thanks to a clinical tool developed by CIHR-funded Dr. Jolanda Cibere. Dr. Cibere was a PhD student in Health Care and Epidemiology at the University of British Columbia when she developed the tool, which uses MRI, x-ray, biomarkers, clinical assessment and questionnaires to comprehensively assess patients with knee pain. The tool is now being used by the National Institutes of Health in the United States as part of its Osteoarthritis Initiative to ensure data are reliable and standardized.
• CIHR researcher Dr. John Wallace, and his research team at the University of Calgary, have identified a pain receptor they believe is linked to inflammatory diseases such as arthritis. Their discovery could spur the development of new drugs that help people cope by blocking the receptor.
• Women are less likely to have hip or knee replacements than men, according to research by CIHR-funded Dr. Gillian Hawker of the University of Toronto. She found that more than twice as many women as men (45 of every 1,000 women compared to 21 of every 1,000 men) in two regions of southern Ontario needed the surgery, but only 1.6 out of every thousand 1,000 women actually have it, compared to 5.6 of every thousand 1,000 men. She concludes that the shortfall is an issue of trust between patients and doctors as well as the intimidation elderly women with arthritis face.

Formally launched by the World Health Organization, and endorsed by the United Nations in 2000, the years 2000-2010 have been officially designated as the Bone and Joint Decade. In late 2002 the Minister of Health, endorsed the movement on behalf of the Government of Canada. IMHA is an active member of the Canadian National Action Network representing over 25 national partner organizations working to advance the awareness of bone and joint health in Canada.
Canadian website: www.bdjcanada.org
International website: www.boneandjoint-decade.org

The Institute

CIHR’s Institute of Musculoskeletal Health and Arthritis (IMHA), under the leadership of Dr. Cyril Frank, supports research to enhance active living, mobility and movement and to address causes, prevention, screening, diagnosis, treatment, support systems and palliation for a wide range of conditions including arthritis, which is the largest subset of all muscu-loskeletal disorders. Its three research priorities are: physical activity, mobility and health; tissue injury, repair and replacement; and pain, disability and chronic diseases.

The Partners

CIHR recognizes the unique role of, and works closely with, all partners in the research process. Its Institute of Musculoskeletal Health and Arthritis, together with The Arthritis Society and the Canadian Arthritis Network, convened the first-ever Osteoarthritis Consensus Conference in April 2002. This gathering of researchers, clinicians, policymakers and patients represented a collaborative, cohesive, and focused effort to identify specific targets for osteoarthritis research.

As a follow up to the OA conference, the three partners, together with the Cochrane Collaboration and the Canadian Arthritis Patients Alliance, came together to form the Alliance for a Canadian Arthritis Program, a strategic alliance committed to creating an overarching National Arthritis plan. The same group also worked in partnership in 2002 to support CIHR’s first knowledge translation workshop.

An integral partner, the Canadian Arthritis Network, a member of the Networks of Centres of Excellence, is dedicated to creating a world free of arthritis through integrated, trans-disciplinary research and development. It links 120 leading Canadian arthritis researchers and clinicians, 40 Canadian academic institutions, The Arthritis Society, pharmaceutical and biotechnology companies, and government. Each year, The Arthritis Society dedicates a half million dollars to CAN to support its training of young, highly qualified personnel – the foundation of all research in this country.
Website: www.arthritisnetwork.ca

The People

When Anne Dooley was first diagnosed with rheumatoid arthritis, in 1996, she was optimistic.

“Well, it could be worse,” she said to her doctor. “What can we do about it?”

It did get worse. She has had reconstructive surgeries on each hand. At one point, she was in so much pain that she couldn’t reach for a piece of paper.

But it also got better. Medication – six pills a day, plus an injection every six weeks – has enabled her to return to an active life. Despite a few side effects and an occasional flare-up, Ms. Dooley is grateful for the research that helped to get her this far.

“My grandfather was diagnosed with rheumatoid arthritis years ago. The only things he had available to him at that time were aspirin and horse liniment. We have come a long way since then,” she says. “Research helped determine that aggressive treatment is needed from the beginning, but we need more research into what rheumatoid arthritis does to people. We also need to determine what this disease does to the family, community and to the workplace.”

Ms. Dooley’s road to diagnosis was a long one. An active outdoorswoman, she originally thought the pain in her joints and swollen wrists were tendonitis. Her family practitioner dismissed her ailments as the aches that come with age. But when her symptoms persisted, Ms. Dooley got a second opinion – and a new direction for her life.

Today, she is Vice President of the Canadian Arthritis Patient Alliance, Co-Chair of Research and Chair of Communications. Her job is to raise public awareness about the pain, disability and cost of arthritis – and about the important role of research.

“Results of research don’t stop at a pill bottle,” she says. “They continue and build.” Ms. Dooley believes research works best when it involves a broad range of people. She calls CIHR’s National Conference on Appropriate Use of Placebos in Clinical Trials “the best conference I ever attended” because of the broad mix of attendees, including researchers, clinicians, policy-makers, and patients. She says that researchers interacting with patients will lead to better clinical trials and, ultimately, better research results.

“As far as I’m concerned,” she says, “research and communication go together.”

About the Canadian Institutes of Health Research

The Canadian Institutes of Health Research is the Government of Canada’s premier agency for health research. Its objective is to excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system.

For more information, visit: www.cihr-irsc.gc.ca.