ARCHIVED - Research About – Arthritis

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The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health-care system. Composed of 13 Institutes, CIHR provides leadership and support to nearly 12,000 health researchers and trainees across Canada. Through CIHR, the Government of Canada invested approximately $23.1 million in 2007-08 in arthritis-related research across Canada.

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The Facts

• Arthritis is a category of disease that includes more than 100 conditions, such as osteoarthritis, lupus, fibromyalgia, gout and scleroderma.
• Arthritis is not just a disease of the elderly. It can strike anyone at anytime, regardless of age or health. In 2000, three of every five people with arthritis were younger than 65.
• The most common type of arthritis in Canada is osteoarthritis, affecting 1 in 10 Canadians.
• Rheumatoid arthritis is the second most common type of arthritis, affecting 1 in 100 Canadians. It is an autoimmune disorder, in which the immune system attacks healthy joints, resulting in damage to cartilage, bone, tendons and ligaments.
• Arthritis affects nearly twice as many Canadian women as men.
• Arthritis costs Canadians more than $4 billion each year in health-care expenses and lost productivity.
• It is estimated that by 2026, more than 6 million Canadians over the age of 15 will have some form of arthritis.

(Source: The Arthritis Society of Canada)

Finding Solutions

Keeping fit with childhood arthritis

CIHR-supported researchers have shown that kids with juvenile idiopathic arthritis (JIA) can stay active and keep fit, whether it's with high- or low-intensity activities. JIA is a painful condition that limits a child's ability to move, making physical activity difficult. But Dr. Brian Feldman and his team at The Hospital for Sick Children in Toronto recently recruited two groups of children with JIA to participate in a 12-week session of either high-intensity aerobics or low-intensity qi gong (a traditional Chinese form of meditation and exercise). At the end of the twelve weeks, both groups showed similar improvement in physical function, but the children in the qi gong group were more likely to stick with the exercise program.

Predicting who will fall

Falling is a major cause of injury in the elderly, especially among people with osteoarthritis. CIHR-supported researchers are using a test to help identify and protect those who are at the greatest risk of losing their balance. Dr. Catherine Arnold at the University of Saskatchewan has determined that the Timed Up & Go (TUG) test, an assessment of how quickly a person can stand up, can be used to predict an arthritis sufferer's risk experiencing a near-fall. This finding could help prevent life-threatening hip fractures in the elderly.

Controlling calcium to treat disease

The discovery of a biological mechanism that blocks bone growth could lead to new treatments for a host of diseases. Dr. Marc McKee, a CIHR-funded researcher at McGill University, has demonstrated that a small molecule, known as pyrophosphate (PPi), blocks the build up of calcium in tissues (a process known as calcification) by triggering the release of a protein known as osteopontin. When unregulated, calcification can lead to ailments such as arthritis and heart disease. Next, Dr. McKee and his team will see if derivatives of PPi can be used to stop calcification in joints and blood vessels.

The Researchers

Dr. Hyon Choi – Statins for the Joints?

Does a major heart-health medication also help those with rheumatoid arthritis? University of British Columbia researcher Dr. Hyon Choi says it's a definite 'maybe'.

Statins are a class of drugs widely used to reduce blood fat (lipid) levels and thus reduce the risk of cardiovascular disease. But in those with rheumatoid arthritis, there are hints from several studies that statins don't just lower lipid levels, they also reduce the inflammation that's at the core of rheumatoid arthritis.

"The statins appear to not only affect lipid levels, but also have anti-inflammatory effects," says Dr. Choi a rheumatologist at the Vancouver General Hospital. "The big question is could statins actually prevent or slow the onset of rheumatoid arthritis, or reduce the severity of the disease?"

This inflammatory disease isn't just painful, it's deadly. Those with rheumatoid arthritis often die prematurely due to heart disease. It's thought that the molecules associated with inflammation also weaken the cardiovascular system. So, if statins reduce both lipid and inflammation levels, they'd pack a double punch to alleviate the suffering, and prolong the lives of thousands of Canadians with aching, inflamed joints.

To tease out the statin answer, Dr. Choi is leading a CIHR-supported study that's taking a big-picture approach. He's using British Columbia health databases covering about 4.5 million patients, and sophisticated statistical tools, to look for links between statins and rheumatoid arthritis.

For example, does statin therapy dramatically reduce the risk of heart disease and death in patients with pre-existing rheumatoid arthritis? Or, when studied at a population level, will we find that there are adverse effects of statins on those with rheumatoid arthritis?

If the statin results for rheumatoid arthritis are positive, Dr. Choi says one health policy issue is already clear: As inexpensive generic drugs, statins could easily be added to antirheumatic regimens to help prevent heart disease and death associated with rheumatoid arthritis.

For more information, go to http://www.impact.cihr-irsc.gc.ca/.