As one of the leading causes of disability in Canada, arthritis affects people of every age, physical condition and ethnic background. One in six Canadians has arthritis and the number is growing at an alarming rate. Every September, The Arthritis Society uses Arthritis Awareness Month to heighten understanding of this disease and raise much-needed funds for arthritis research and services.

This September, The Arthritis Society is highlighting the staggering impact of arthritis on Canadian workers. People with arthritis have daily struggles that their co-workers don’t face. Symptoms like pain and stiffness of arthritis can interfere with the ability to perform work-related tasks. The high prevalence of arthritis among working-age Canadians has devastating consequences for the workplace. While many men and women with arthritis work, a recent Public Health Agency of Canada report found that 44 per cent are working with job limitations and 33 per cent require job modifications.

Click here to get the Arthritis in the Workplace booklet.

Keep checking our website for new information and updates on events in your community.

 The Canadian Agency for Drugs and Technologies in Health (CADTH) recently conducted a therapeutic review to evaluate the comparative effectiveness, harms, and cost-effectiveness of biologic response modifier agents for adults with rheumatoid arthritis. The recommendations report from the Therapeutic Review Panel is available at Access reports and summaries.

Study Suggests Environmental Factors May Be Cause of Increase  

The incidence of rheumatoid arthritis (RA) in women has risen during the period of 1995 to 2007, according to a newly published study by researchers from the Mayo Clinic.  This rise in RA follows a 4-decade period of decline and study authors speculate environmental factors such as cigarette smoking, vitamin D deficiency, and lower dose synthetic estrogens in oral contraceptives may be the source of the increase.   Details of the study which includes more than 50 years of RA epidemiology data appear in the June issue of Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology.  

Between 1 and 2 million Americans suffer the effects of RA, a chronic inflammatory disease that targets joints and which contributes to work-related disability, increased morbidity, and shortened survival.  Up to one-half of all RA patients become unable to work within 10-20 years of follow-up and those with the disease have a 60% to 70% higher mortality risk than those in the general population.  Furthermore, studies show that RA treatments alone account for $9 billion in excess health care costs with direct and indirect costs expected to exceed $39 billion annually.

 The current study, led by Sherine Gabriel, M.D., M.Sc., expanded on prior research (1955-1994) from the Mayo Clinic team, by determining RA incidence and prevalence between 1995 and 2007.  Researchers screened medical record of 1,761 Olmsted County, Minnesota residents 18 years and older who had received 1 or more diagnoses of arthritis (excluding degenerative arthritis or osteoarthritis).  After thorough review of all medical records, a diagnosis of RA was made in 466 patients whose mean age at RA incidence was 55.6 years, with 321 females (69%) in the study cohort.  

“We observed a modest increase of RA incidence in women during the study period, which followed a sharp decline in incidence during the previous 4 decades,” said Dr. Gabriel.  Results show that RA incidence in women increased by 2.5% per year from 1995 to 2007, while a decrease of 0.5% was noted for men.  Researchers did not find a disproportionate increase in RA incidence in any particular age group over the study period.  “As expected we found an increase in RA prevalence during the same time period,” added Dr. Gabriel.  The overall age- and sex-adjusted prevalence of RA increased from 0.62% in 1995 to 0.72% in 2005.

Prior studies have clearly demonstrated that cigarette smoking is associated with a greater risk for RA development in both sexes.  While smoking rates in the U.S. are declining, the rate is significantly slower in women than men, which researchers believe may, in part, explain the modest increase of RA incidence in women.  Researchers also note that lower doses of estrogens found in modern oral contraceptives offer less protection against RA development then at the previously higher doses found in older medications, which they suspect may contribute to the increased RA incidence among women.  Furthermore, several studies have shown vitamin D deficiency to be associated with RA development and coupled with evidence that this deficiency, particularly in women, has risen over the past decades the Mayo team considered it a possible contributor to the upward trend in RA. 

In an editorial also published in this month’s issue of Arthritis & Rheumatism, Dr. Ted Mikuls of the University of Nebraska Medical Center remarked, “Public health measures are already under way to address many of the environmental risk factors that have been implicated in RA risk, including interventions that encourage smoking cessation and efforts focused at optimizing levels of physical activity, vitamin D intake, and oral hygiene.”

Dr. Gabriel concluded, “Reasons for the increase in incidence we found are unknown, but environmental factors likely play a role and should be further explored.”

To view the abstract, click here.

(Source: Wiley-Blackwell)

Canadians will benefit from new insights into the link between physical activity and health as the Honourable Leona Aglukkaq, Minister of Health, today announced funding for four research teams through the Canadian Institutes of Health Research (CIHR). These teams will study the effects of exercise on the body and its role in the prevention and treatment of chronic diseases including arthritis, breast cancer and heart disease.

"Our Government encourages Canadians to be physically active as part of a healthy lifestyle," said Minister Aglukkaq. "Today's investment in research will help develop new strategies for using exercise to prevent and treat major diseases affecting Canadians."

The teams announced today will be led by the following researchers:

Dr. John Esdaile (Arthritis Research Centre of Canada; Centre for Hip Health and Mobility, Vancouver General Hospital; and University of British Columbia, Vancouver, BC) and his team will explore the link between physical activity and hip osteoarthritis.

Dr. Kevin Shoemaker (University of Western Ontario, London, ON) and his team will investigate the effect of cardiovascular disease on the health of nerves that control muscle function and mobility.

Dr. Kerry Courneya (University of Alberta, Edmonton, AB) and his team will study how physical activity and the fitness level affect the survival and long-term health of patients diagnosed with breast cancer.

Dr. Ciaran Duffy (McGill University, Montreal, QC) and his team will examine the role of physical activity in improving the health and well-being of children with arthritis.

"We are very proud to be supporting these four talented teams," said Dr. Jane Aubin, Scientific Director of the Canadian Institute of Health Research's Institute of Musculoskeletal Health and Arthritis. "By supporting this research we will help improve the health and quality of life of Canadians and reduce the burden on Canada's health care system."

The teams were selected through a rigorous process of competitive peer review. They will each receive $2.5 million over five years for a total investment of $10 million.

Dr. John Esdaile, Scientific Director of the Arthritis Research Centre of Canada, spoke at the announcement about his team and the potential impact of its work. "We believe we can detect osteoarthritis of the hip much earlier than we have in the past," said Dr. Esdaile. "By catching it early, before it causes damage, we open the door to preventing hip osteoarthritis, which means we avoid costly surgery and greatly improve the quality of life of Canadians who experience hip pain."

(Source: CNW)

The Project for an Ontario Women's Health Evidence-based Report (POWER) recently a Women's Health Report to serve as an evidence-based tool for policy makers, providers and consumers in their efforts to improve health and reduce health inequities among Ontario women.

One of the chapters in the report specifically addresses muculoskeletal (MSK) conditions which can limit physical function, impose significant pain and suffering and are the number one cause of disability in Ontario. As a result, the associated costs to the health-care care system and to society are staggering. The MSK conditions chapter examines condition-specific prevalence, indicators of health and functional status, access and utilization of services and clinical care indicators for osteoarthritis, rheumatoid arthritis and osteoporosis. Performance indicators for women and men are addressed as are differences by income, education, age and geography.

To download a copy of the full chapter or the highlights document (which outlines the chapter's key findings and messages), please go to:  http://www.powerstudy.ca/the-power-report/the-power-report-volume-2/musculoskeletal-conditions

(Source: POWER)

The already staggering social and economic costs of arthritis in Canada are set to explode during the coming decades, says The Arthritis Society in response to a report released by the Public Health Agency of Canada today.

Life with Arthritis in Canada documents the latest trends and data regarding arthritis among Canadians over the age of 15.

“The devastating impact of arthritis on Canadian society has gone unnoticed in the public arena for too long,” said Steven McNair, President and CEO of The Arthritis Society. “This report confirms that arthritis is becoming a major health challenge for Canada, as more people consume more health-care resources to manage their pain and disability. This means we need to step up our efforts to find better treatments and a cure.”

Among the report’s many findings:

• Arthritis is among the leading causes of disability in Canada, costing the Canadian economy $6.4 billion every year in health-care expenses and lost work days. Long-term disability accounts for two-thirds of that.
• More than four million Canadians aged 15 and older (16 per cent of the population) reported they had arthritis in 2007-2008, with three out of five being under 65. This number is estimated to increase to seven million by 2031.
• Arthritis is the second and third most common chronic condition reported by women and men, respectively.
• Arthritis accounted for six per cent of all hospitalizations in Canada in 2005-2006 (132,000 out of 2.2 million).
• Joint replacements more than doubled in Canada from 2001-2005.

Arthritis affects people of every age, physical condition and ethnic background. There are more than 100 types of arthritis, caused by joint inflammation and degeneration. According to the report, about 60 per cent of Canadians with the disease report difficulties with participating in recreation, leisure, hobbies or social activities.

The Arthritis Society says many of the risk factors associated with arthritis, such as physical inactivity and poor diet, can be modified to reduce pain and increase joint flexibility. “We hope this report will serve as a wake-up call for people to take control of their disease through a healthy lifestyle and with the benefit of current treatments,” added McNair.

Life with Arthritis in Canada brings together data from national population health surveys, provincial physician billing, drug databases, hospital admissions and mortality statistics, among other sources.  It was developed in consultation with leaders from the scientific and research community, as well as stakeholder groups such as The Arthritis Society. 

Risk of GI Bleeding Varies by Drug and Dose

A study conducted at the Spanish Centre for Pharmacoepidemiological Research revealed that the risk of gastrointestinal complications due to nonsteroidal anti-inflammatory drug (NSAID) use varies by specific NSAID administered and by dosage.  The study further determined that NSAIDs with a long half-life or slow-release formulation are associated with a greater risk of GI bleeding or perforation. Study findings are published in the June issue of Arthritis & Rheumatism, a journal of the American College of Rheumatology.

NSAIDs such as Advil, Motrin and Aleve, are drugs that treat pain and inflammation by blocking the action of two cyclooxygenase (COX) enzymes. COX-2 promotes inflammation, but COX-1 protects the lining of the stomach. If an NSAID inhibits both COX-1 and COX-2, GI bleeding and ulcers can result.

According to the American College of Gastroenterology, it has long been recognized that persons using NSAIDs are at a significantly increased risk of gastrointestinal complications, for instance, injury to the intestinal lining that can result in ulcers and/or gastrointestinal bleeding. With millions taking NSAID pain medications every day, it is estimated that more than 100,000 Americans are hospitalized each year and between 15,000 and 20,000 Americans die each year from ulcers and gastrointestinal bleeding linked to NSAID use.

To reduce the morbidity associated with NSAIDs, specific estimates for individual drugs and individual groups of patients with different risk profiles are needed. This study assessed the risk of upper GI bleeding and perforation among individual NSAIDs and analyzed the correlation between this risk and the degree of inhibition of whole blood COX-1 and COX-2 in vitro.

The research team conducted a systematic review of nine observational studies on NSAIDs and upper GI bleeding/perforation published between 2000 and 2008. The article criteria was 1) report case–control or cohort studies evaluating traditional NSAID or coxib use and upper GI bleeding/perforation in the general population, and 2) provide either an estimate or enough data to estimate a relative risk comparing NSAID users with nonusers. The pooled relative risk (RR) estimates of upper GI bleeding/perforation for individual NSAIDs was calculated, as well as whether the degree of inhibition of whole blood COX-1 and COX-2 in vitro by average circulating concentrations predicted the RR of upper GI bleeding/perforation.

The analysis suggests that NSAID-associated upper GI toxicity is the result of two pharmacologic features: drug exposure and sparing of COX-1 activity. These findings support the notion that there are multifactorial determinants in the risk of upper GI bleeding/perforation among NSAID users, including clinical background, use of concomitant medications, or a possible genetic susceptibility.

Study leader Luis A. García Rodríguez, M.D. states, “We showed that persistent exposure to the drug is an important independent determinant; in fact, drugs with a long half-life or slow-release formulation were associated overall with a greater risk than NSAIDs with a short half-life. We observed the lowest GI toxicity with coxibs, i.e., celecoxib and rofecoxib, which supports the notion that sparing of COX-1 in the GI tract and possibly in platelets translates clinically to a lower upper GI risk.”

To view the abstract, click here.

(Source: Wiley-Blackwell)

Cardio-Respiratory Aerobic Conditioning Improves Function; Lessens Joint Pain

Researchers from the University of Grenoble Medical School in France determined that cardio-respiratory aerobic exercise is safe for patients with stable rheumatoid arthritis (RA).  The team found that RA patients who exercised regularly had improved function, less joint pain, and greater quality of life.  Full findings of the study are now available online and will publish in the July print issue of Arthritis Care & Research, a journal of the American College of Rheumatology.

RA, a chronic inflammatory disease characterized by swollen joints, pain, stiffness, fatigue, and general malaise affects up to 1% of the global population, according to the World Health Organization (WHO).   The Centers for Disease Control and Prevention (CDC) citing health-related quality of life (HRQL) studies found that RA patients were 40% more likely to report fair or poor general health and twice as likely to have a health-related activity limitation compared with those without arthritis.

The current study led by Athan Baillet, M.D., conducted an abstract search of relative medical journals for studies that researched RA patients and impact of aerobic exercise.  The team analyzed 14 studies and meta-analysis included 510 patients in the intervention group and 530 in the control group. Participants in these studies had a mean age of 44-68 years and their RA disease duration was 1-16 years.  Researchers compared HRQL, the Health Assessment Questionnaire (HAQ), joint count, and pain using a visual analog scale (VAS) among patients in the studies.\

“Our results show that patients with stable RA would benefit from regular aerobic exercise,” said Dr. Baillet.  “Cardio-respiratory conditioning appears safe and its effects, while small, help to reduce joint pain and improve function.”  Researchers assessed the efficacy of exercise on RA symptoms using standardized mean differences (SMDs) which is the difference (between groups) of mean outcome variation from baseline/SD at baseline of aerobic exercises versus non-aerobic rehabilitation.  Meta analysis of the research showed that exercise improved the post-intervention quality of life (SMD=0.39), HAQ score (SMD=0.24), and pain VAS (SMD=0.31).   The difference in scores between those who exercised and those who had not are considered clinically meaningful by both patients and doctors noted the researchers. 

The American College of Rheumatology states that exercise is beneficially for everyone, including those with RA, and currently recommends 150 minutes of moderate intensity aerobic activity each week.  Safe forms of aerobic exercise, such as walking, aerobic dance, and aquatic exercise, help arthritis patients to control weight, and improve sleep, mood, and overall health. 

“While past studies have indicated that RA patients are quite physically inactive, our study shows aerobic exercise to be a safe and beneficial intervention for this group.  Further trials are needed to clearly determine the clinical impact of cardio-respiratory conditioning in the management of RA,” concluded Dr. Baillet.

To view this article, click here.

(Source: Wiley-Blackwell)

Cartilage Loss Plays a Role in Development of Osteoarthritis, Study Says 

A recent study determined that bone area predicted the development of medial (inner side) and lateral (outer side) knee cartilage damage and loss of medial cartilage volume.  Subchondral bone mineral density (BMD) was associated with medial defect development but not cartilage loss. Researchers believe subchondral bone changes and loss of cartilage contribute to the development of osteoarthritis (OA). Read details of the study online or in the July issue of Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology. 

According to a report by the World Health Organization (WHO), 9.6% of men and 18% of women over 60 years of age worldwide have OA symptoms, making it a leading cause of disability. OA is caused by the gradual loss of cartilage and underlying bone, typically affecting the knee, hip, hand, and spine joints. The Centers for Disease Control and Prevention estimate that 4.3 million Americans over age 60 have symptomatic knee OA, the most common joint affected. In fact prior studies of U.S. and European populations (over 45 years of age) show higher rates of knee OA in 14.1% of men and 22.8% of women (WHO report).

Ph.D. candidate and lead author of the study, Dawn Dore´, enrolled 341 participants in their prospective study. Participants had a mean age of 63 years and provided measurements of tibial knee cartilage volume, cartilage defects, and bone area using magnetic resonance imaging (MRI). The tibial subchondral BMD was determined using dual x-ray absorptiometry (DXA). Follow-up measurements of cartilage volume and defects were taken 2.7 years later. 

Study results found that baseline bone area positively predicted cartilage defect development at the medial and lateral tibial sites (odds ratio [OR] 1.6 and OR 2.4 per 1 SD increase, respectively). Cartilage volume loss at the medial tibial site was also positively predicted by baseline bone area (ß -34.9 per 1 SD increase). However, baseline subchondral BMD positively predicted cartilage defect development at the medial tibial site only (OR 1.6 per 1 SD increase) and was not associated with loss of cartilage.

“Our results clearly show bone area was a predictor of cartilage defect development in the inner and outer knee, as well as medial cartilage volume loss,” said Ms. Dore´. “We found that subchondral BMD only predicted defect development on the inside of the knee, but not cartilage loss”. Researchers noted that the associations were independent of each other and suggest there are multiple mechanisms where changes in subchondral bone could lead to cartilage damage. “With the ability to predict those at risk of developing knee OA, early interventions can be offered to patients in order to lessen the disabling affects of this disease,” concluded Ms. Dore´. 

To view this article, click here.

(Source: Wiley-Blackwell)

Higher Levels of Antibodies May Be Linked to Disease Severity and Progression

University of Texas Medical Branch researchers have uncovered an association between free radical-mediated reactions and the severity and progression of system lupus erythematosus (SLE). Higher levels of oxidative and nitrosative stress markers were found in SLE patients with greater disease activity suggesting a causal relationship. Full findings of the study are available in the July issue of Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology.

Lupus, an autoimmune disease in which the body¡¯s immune system produces antibodies against itself, causes inflammation, joint pain, fatigue, as well as tissue and organ damage. Approximately 1.5 million Americans and 5 million people worldwide have a form of lupus according to the Lupus Foundation of America with SLE accounting for 70% of all cases. Experts estimate that 70% to 90% of those with this chronic and potentially life-threatening disease are women. 

While prior studies have suggested an association between oxidative and nitrosative stress and autoimmunity in mice, its relevance in SLE disease development and progression in humans is not fully understood. To explore the link between reactive oxygen and nitrogen species (RONS) and SLE, M. Firoze Khan, Ph.D., and colleagues used serum from 72 patients (62 female and 10 male) with SLE and 36 healthy control subjects (31 female and 5 male) in their study. The mean age was 47.2 years for the SLE group and 43.1 years in the control. Researchers used the SLE Disease Activity Index (SLEDAI) scores to measure disease activity which ranged from 0 to 38 (mean 10.7). SLE participants were divided into 2 groups¡ªthose with a low SLEDAI score of <6 and those with a higher score of ¡Ý6.

Blood levels of oxidative and nitrosative stress markers, including antibodies to malondialdehyde (anti-MDA), 4-hydroxynonenal (anti-HNE), MDA/HNE protein adducts, superoxide dismutase (SOD), nitrotyrosine (NT), and inducible nitric oxide synthase (iNOS) were evaluated in each sample. ¡°Our analysis showed significantly higher levels of anti-MDA and anti-HNE antibodies (biomarkers of oxidative stress) in SLE compared with healthy controls,¡± said Dr. Khan. Researchers also found that the levels of both these antibodies were significantly higher in lupus patients whose SLEDAI scores were greater than 6, suggesting that increased lipid peroxidation is associated with SLE disease progression. 

¡°Our results clearly show significant increases in oxidative and nitrosative stress in lupus patients suggesting that there is an imbalance between RONS production and antioxidant defense mechanisms in SLE,¡± concluded Dr. Khan. ¡°Longitudinal studies are needed to further establish how free radical-mediated reactions contribute to SLE development, and to determine the value of anti-MDA and anti-HNE antibodies in assessing the progression and severity of the disease.¡±

To view this article, click here.

(Source: Wiley-Blackwell)

Health Canada has launched a new Consumer Side Effect Reporting Form to make it even easier for consumers to report side effects to drugs and other health products to the Canada Vigilance Program.

Reporting side effects, also known as adverse reactions, is important to health product safety. Each report may contribute to improving the safe use of health products - including prescription and non-prescription drugs, and natural health products.

"Improving health product safety is in everyone's best interest, and everyone has a role to play," said the Honourable Leona Aglukkaq, Minister of Health. "The new form is one way Health Canada is making it easier for Canadians to report suspected adverse reactions, and for us to improve the safety and safe use of health products for all Canadians."

Information received from adverse reaction reports is combined with other sources of safety information and may help identify previously unrecognized, rare or serious adverse reactions, and may lead to changes in product safety information or other regulatory actions.

Click here to see the full News Release.

(Source: Health Canada)

A research group has conducted a project to define ways of treating rheumatoid arthritis (RA) among the elderly. The first portion of this work surveyd health-care practitioners. The results confirmed that, to some degree, many older adults with RA are diagnosed based on belief rather than evidence.  The second portion of the project consisted of seminars to educate the survey respondents about ageism, how it can influence health care and ways to look at evidence–based options when prescribing treatments.

The aim of this work was to increase awareness about ageism in arthritis care and to develop a new approach to managing RA in older adults. By educating health-care professionals about ageism and sharing evidence-based treatments for RA with an older population, health-care providers will be able to adjust their approach to RA treatment for the elderly to ensure that people living with RA receive the appropriate treatments and care regardless of their age.  

(Source: Dr. Camerlain)

Almost 3,500 people in 16 cities across Canada participated in the first national Walk to Fight Arthritis yesterday and raised $900,000 to help find a cure for one of the leading causes of disability among Canadians.

“By all accounts, this was an incredible event and we couldn’t have done it without the dedication and generosity of everyone involved including our major sponsor, the makers of TYLENOL^®,” said Steven McNair, President and CEO, The Arthritis Society.

“By raising money for and awareness of arthritis, we have a real chance to find a cure for this debilitating disease that affects more than four million Canadians,” he added. “It was truly inspiring to see so many people join together to help fight arthritis.” 

Canadian hockey legend Wendel Clark joined the Toronto walk to support his mother-in-law and many friends and former hockey mates who suffer from the disease.

“This was a fantastic event and a great way to spend a Sunday together with family and friends,” said Clark.  “It feels good to know I helped raise awareness for such an important cause.”

Wendel and other walk participants wore symbolic Blue Badges to help demonstrate the many faces of arthritis, a disease that doesn’t just affect older people.

Participating walk communities were:

• St. John’s
• Halifax
• Montreal
• Ottawa (May 16)
• Kingston
• Toronto
• Etobicoke
• Hamilton
• Kitchener
• London
• Windsor
• Sudbury
• Thunder Bay
• Winnipeg
• Moose Jaw
• Calgary
• Vancouver

Many participants also joined the fight online through a Virtual walk.

The Fight Against Arthritis Continues
Canadians are still encouraged to visit www.WalktoFightArthritis.ca to make a pledge for the Walk or to share their personal story of living with arthritis. For every approved story submitted by June 15, the makers of TYLENOL^® will donate $5 to the Walk (up to a maximum of $20,000 CDN).

“Everyone has a story to share about their fight against arthritis, and the more people talk about the disease, the more awareness is generated,” said McNair.  “Whether sharing tips for managing arthritis or simply connecting with others affected by it, the stories will continue the momentum toward finding a cure.”

Canadians can also contact The Arthritis Society at 1-800-321-1433 or www.arthritis.ca for information on how to manage their arthritis or to donate to help find a cure. Additional information on managing arthritis pain can also be found on www.livingwell.ca.

Click here to read the full News Release.

Register now for fundraising events taking place across the country on Sunday, May 30

Affecting more than four million Canadians, arthritis is the leading cause of disability in Canada and can cause debilitating pain for those who suffer from this incurable disease.(1) To help raise awareness and funds for a cure, The Arthritis Society is launching the Walk to Fight Arthritis, presented by the makers of TYLENOL^®- a fundraising event taking place in locations across Canada this month.

"Arthritis doesn't just affect older people - in fact, nearly three of every five people with arthritis are under the age of 65," says Steven McNair, President and CEO, The Arthritis Society. "Arthritis is among the top three most common chronic diseases in Canada - and the Walk to Fight Arthritis aims to change the face of the disease and put us one step closer to finding a cure."

Arthritis is a cause that's close to Canadian hockey legend, Wendel Clark; his mother-in-law, along with many friends and former hockey mates suffer from the disease. Wendel is one of the many participants who will walk in Toronto on May 30 and join others by proudly wearing a symbolic Blue Badge to show his connection to the cause and the fight against arthritis.

"I'm thankful that I personally haven't developed arthritis, but I know it can happen - and I see how deeply it affects the people I care about every day," said Wendel Clark. "It's so important to raise awareness for this debilitating disease. By registering for a local walk and raising pledges, Canadians do just that, while helping to fund leading-edge research and essential programs too."

In addition to raising funds through pledging, Canadians are encouraged to visit www.WalktoFightArthritis.ca to share their personal story of living with arthritis. For every approved story submitted, the makers of TYLENOL^® will donate $5* towards the Walk to Fight Arthritis.

Click here to read the Press Release.

Click here to register.

Study Shows Lifestyle Interventions Improve Pain and Function

A recent study found that individuals with knee osteoarthritis (OA) who made lifestyle changes within 6 months of diagnosis, saw improvement in function and experienced less pain.  About three-quarters of study participants started exercising, one-third initiated activity aids (knee taping, acupuncture), and one-third started taking natural medicine products.  Most patients made these changes to their lifestyle on their own, without advisement from health care professionals.  Details of the study appear in the April issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology.

OA is the most common form of arthritis and contributes to half of all disability among older persons in North America.  According to the Centers for Disease Control and Prevention (CDC), approximately 4.3 million Americans over age 60 have symptomatic knee OA.  Past studies have reported that OA of the knee has significant impact on health-related quality of life (HRQOL), with 40% of those with the disease having indicated their health to be “poor” or “fair” (NHAMES III data).

In the current study, pharmacists at 27 pharmacies in the Greater Vancouver Regional District of British Columbia and in the city of Edmonton, Alberta, Canada recruited participants who had pain, aching, or discomfort in the knee during the previous year and determined eligibility using a screening questionnaire.  The pharmacists identified 190 subjects with previously undiagnosed knee OA.  Participants had a mean age of 63 years and were mostly white women who were either overweight or obese.  Carlo Marra, Pharm.D., Ph.D., and colleagues from the University of British Columbia assessed participants for health services, product use, and HRQOL at baseline, 1,3, and 6 months following diagnosis of knee OA.

Results showed that in the first month less than 50% of subjects initiated aerobic, strength or endurance exercises such at biking or walking.  By month 6 nearly 75% of participants claimed to engage in routine exercise and 80% of those who did exercise stated it helped ease their condition.  Activity aids such as acupuncture, knee tape, knee braces and shoe inserts were used by 33% of participants and 75% found this to be helpful.  Researchers also reported that by the end of the 6-month study period, 93% of participants had visited a primary care physician to discuss their knee OA diagnosis.

Analgesic therapy was started by 52% of study subjects, 36% began taking natural medicine supplements and 66% started therapy from one or both categories.  About 50% of participants took nonsteroidal anti-inflammatory drugs (NSAIDs) and roughly 25% tried acetaminophen.  For participants using natural supplements, 60% took glucosamine alone and 40% used a combination of glucosamine with chondroitin.  By the end of the 6-month period, 50% of study subjects stated that the analgesics and natural supplements were beneficial in managing their knee OA.

“Most concerning was the greater number of participants who opted to first use NSAIDs prior to trying acetaminophen which is the treatment of choice for knee OA pain relief,” said Dr. Marra.   “The limited involvement of pharmacists in patient care was unexpected since our study introduced the pharmacist as the first point of contact for participants.”  A recent study by Hay et al. found that medication reviews by a pharmacist can reduce potentially dangerous NSAID use in those with knee OA.

More than 50% of study subjects stated they decided to start exercising, using activity aids, or taking analgesics on their own.  Family physicians were the second most cited contact, followed by family members or friends.  “It is encouraging that participants initiated exercise regimens within 6 months of their diagnosis, but surprising that so few credited a health professional with the decision to become more active,” commented Dr. Marra.  “This observation is an important consideration for the development of arthritis management programs that target early disease management and initiation of appropriate analgesic therapy.”

To view this article, click here.

(Source: Wiley-Blackwell)

Roche today announced that Health Canada has approved ACTEMRA(TM) (tocilizumab) to treat patients with rheumatoid arthritis (RA), a chronic, progressive inflammatory disease of the joints and surrounding tissues that is associated with intense pain, irreversible joint destruction and systemic complications, such as fatigue and anemia.

ACTEMRA is indicated for reducing signs and symptoms in adult patients with moderately to severely active RA who have inadequate response to one or more disease modifying anti-rheumatic drugs (DMARDs) and/or tumour necrosis factor (TNF) antagonists.

General use of ACTEMRA in DMARD-inadequate responder (IR) patients is not recommended at this time. Physicians may consider the use of ACTEMRA in the DMARD-IR population on a case by case basis dependent on disease and patient characteristics, experience with the drug, and the benefits and risks of ACTEMRA as compared to other therapeutic options available.(1)

There are several key cytokines, or proteins, involved in the inflammatory process, including IL-6. Research shows that IL-6 levels are elevated in patients with RA. ACTEMRA is the first medication designed to specifically inhibit the biological activity of IL-6.

Despite the treatment options currently available, many people with RA do not respond adequately in order to achieve remission, subsequently resulting in disease progression and unnecessary pain and suffering.

"The approval of ACTEMRA in Canada allows for a new way of treating RA and offers another treatment option," says Dr. Janet Pope, a rheumatologist and Professor of Medicine at the University of Western Ontario, London, Ontario. "Results in ACTEMRA clinical trials have shown long-lasting relief from symptoms and stopping progression of the disease - and remission in many people - which is truly the ultimate goal of treatment for RA."

"Since I was first diagnosed with RA at the age of 42, my quality of life quickly deteriorated and I was living with constant pain and overwhelming exhaustion," said Ian McKay. "Being unable to perform daily functions that come so naturally to most of us was very taxing on my family. Today, with ACTEMRA, I have my energy back, and I am living life to its fullest."

Health Canada's approval of ACTEMRA was based on results from the largest clinical program undertaken by an RA biologic manufacturer including five multi-national Phase III studies which demonstrated that treatment with ACTEMRA - alone or combination with methotrexate (MTX) or other DMARDs - significantly reduced RA signs and symptoms, compared with current DMARDs alone, as shown by primary and secondary endpoints including ACR and DAS scores. These benefits were seen regardless of previous therapy or disease severity. ACTEMRA is approved for the treatment of RA in the United States, the European Union, and several other countries including Australia, Switzerland, Brazil and India.

Approved for adult patients with RA who have had an inadequate response to one or more DMARDS and/or TNF antagonists, the recommended starting dose of ACTEMRA is every four weeks as an intravenous infusion over one hour to be administered in infusion clinics. It may be used alone or in combination with MTX or other DMARDs at the following dose: 4 mg/kg followed by an increase to 8 mg/kg based on clinical response.

"This announcement is great news for people living with rheumatoid arthritis," said Cheryl Koehn, President of Arthritis Consumer Experts. "Health Canada's approval of tocilizumab will add to the RA treatment arsenal, which is important given that there continues to be significant unmet need in the treatment of this disease. I am hopeful that the Common Drug Review process and subsequent provincial formulary reviews will be completed in a timely manner, and that reimbursement coverage will be made available for tocilizumab as part of the full range of Health Canada-approved arthritis medications."

Provincial formulary coverage of ACTEMRA in Canada will be sought. In the meantime, people who are prescribed this medication by their rheumatologists may be able to access the medication through Jointeffort, part of the Roche Patient Assistance Program (RPAP). Jointeffort program case workers will navigate private insurance plans to determine an individual's coverage.

(Source: Canada NewsWire)

UCBeyond Scholarship Program Provides Opportunities for Students Living with Rheumatoid Arthritis and Crohn’s Disease

UCB Canada Inc. is proud to announce the launch of the 2010 UCBeyond Scholarship Program. During its four-year lifespan, the UCBeyond Scholarship has allocated almost 70 educational bursaries worth close to $350,000.00 CAN to students living with chronic illnesses such as rheumatoid arthritis, Crohn’s disease and epilepsy.
 
Nirupa Varatharasan, a Master of Science student from Dalhousie University, and one of the recipients of the 2009 UCBeyond Rheumatoid Arthritis Scholarships, is one of the beneficiaries of this prestigious award. “Sometimes, it is a struggle just to get out of bed, never mind worrying about working and going to school. That is why this scholarship is such a blessing; it recognizes those of us who look and live ‘normally’ but who battle pain and overcome denial on a constant basis. For that I am truly gracious.”

It is because of stories like Nirupa’s that UCB Canada Inc. continues to help reduce the financial burden faced by students living with rheumatoid arthritis and Crohn’s disease through the UCBeyond Scholarship Program. Now in its fourth year, the UCBeyond Scholarship Program will award eight (8) one-time scholarships of up to $5,000.00 CAN each to people diagnosed with rheumatoid arthritis and eight (8) one-time scholarships of up to $5,000.00 CAN each to people diagnosed with Crohn’s disease. The winners must demonstrate academic ambition and use their scholarship toward post-secondary education (i.e. university, college, trade school, etc.) for the 2010/2011 school year.

An independent selection committee of leading physicians and patient representatives from across the country will choose the 2010 UCBeyond Scholarship recipients. Applicants will be evaluated based on a one-page essay demonstrating how they reach beyond their disease, exhibit perseverance and empower others, as well as two letters of personal recommendation. The deadline to apply is June 30, 2010 and the scholarship recipients will be announced in September 2010.

For more details, download the scholarship information sheet,  the criteria sheet and the application form.

Do you know Canadian doctors, nurses, pharmacists, medical archivists, or patient representatives that are knowledgeable and/or have experience related to electronic health records?
 
We need your help to find people who can contribute their EHR experience to improving future implementation in Canada.

A pan-Canadian research project studying user perspectives of electronic health record (EHR) implementation is currently underway. Your help is needed to make this project a reality.

We would like your help to identify people living in Canada who are knowledgeable about EHR and/or who have been involved with an EHR implementation experience. We are recruiting health professionals - physicians, nurses, pharmacists, and medical archivists - as well as individuals who represent patients (for example, citizens involved with hospital boards or health associations). By filling out this simple online form, you may identify yourself and/or other people who would be interested in participating in this research project on the subject of the barriers and facilitating factors to EHR implementation in Canada. Be assured that any information you send will be treated in a confidential manner and that the participation of suggested persons is voluntary.

To qualify, the participants must speak English or French, have access to the internet, complete at most three short online questionnaires between March 22-30, 2010 and, ideally, have practical experience with an EHR implementation project. The knowledge and the expertise that participants bring to the research is key to its success.

To identify yourself or others as possible participants, please take a few moments to fill out this simple online form.

More detailed information on the project can be found here, as well as information on the research team of Dr Marie-Pierre Gagnon, principal investigator.

(Source: CRCHUQ)

The Honourable Lawrence Cannon, Minister of Foreign Affairs, and the Honourable Diane Finley, Minister of Human Resources and Skills Development, today announced that, with the support of all provinces and territories, the Government of Canada has ratified the Convention on the Rights of Persons with Disabilities at United Nations headquarters in New York City.

“Canada is committed to promoting and protecting the rights of persons with disabilities and enabling their full participation in society,” said Minister Cannon. “Ratification of this convention underscores the Government of Canada’s strong commitment to this goal.”

“Canada is proud to have been one of the first countries to originally sign the Convention in 2007,” said Minister Finley. “The ratification of this agreement is just further acknowledgement that Canada is a world leader in providing persons with disabilities the same opportunities in life as all Canadians.”

“Today is a momentous day for Canadians with disabilities and their families,” said Bendina Miller, President of the Canadian Association for Community Living (CACL). “CACL is thrilled that Canada has ratified the Convention. Canada has been an international leader on disability and human rights, and through ratification can continue to play this important role. CACL looks forward to working with the Government of Canada on implementing and monitoring compliance with the Convention.”

“The Government of Canada’s ratification today of the Convention is a historic event for Canadians with disabilities,” said Marie White, National Chairperson of the Council of Canadians with Disabilities. “It signals the end of an era where people with disabilities were seen as objects of charity. Ratification of the Convention makes real our goal of recognition as full and equal citizens of Canada.

“Ratification of the Convention puts an end to the medical model and opens exciting new opportunities for building a more inclusive and accessible Canada. Canadians with disabilities applaud the Government of Canada for this historic action.”

“As the Government of Canada continues to play a leading role with respect to the inclusion of persons with disabilities in sport, we wish our paralympic athletes the best of luck at the upcoming Paralympic Games in Vancouver,” said Minister Cannon.

The Convention on the Rights of Persons with Disabilities is an international human rights instrument of the United Nations intended to protect the rights and dignity of persons with disabilities. Parties to the Convention are required to promote, protect and ensure the full enjoyment of human rights by persons with disabilities, and to ensure that they enjoy full equality under the law.

There are approximately 4.4 million persons with disabilities in Canada—about 14.3 percent of the population. Click here to see the full article.

To view The Arthritis Society’s Canadian Arthritis Bill of Rights, click here.

(Source: Canada News Centre)

A vast majority of Canadians are not aware of one of the most common chronic childhood diseases, juvenile arthritis (JA), according to a recent national survey commissioned by The Arthritis Society. The Ipsos Reid survey revealed that 80 per cent of respondents, including parents with children below the age of 16, are unfamiliar with the disease. Juvenile arthritis affects 1 in 1,000 Canadian children.

“Life is different and harder for children with arthritis. They have daily struggles that other kids don’t have to face,” notes Dr. Brian Feldman, Vice Chair of The Arthritis Society’s Medical Advisory Committee and head of the division of rheumatology at The Hospital for Sick Children in Toronto. “Children with arthritis often have to miss school and recreational activities because of their many medical visits. In addition to dealing with the sometimes excruciating physical effects of the disease, missing out on these activities can impact children emotionally. Some children with severe forms of juvenile arthritis may require surgery on their joints. Finding a cure is imperative; no child should have to go through this.”

Juvenile arthritis results from the malfunctioning of the body’s immune system. The immune system fails to recognize healthy body tissue and attacks it. Symptoms include intense pain and inflammation of the joints, which can make activities that most children take for granted – buttoning clothing, playing sports or carrying books to school – difficult to perform.  Depending on the severity of the arthritis, some children experience irregular growth or physical disability. Most of these symptoms are not recognized or understood.  In fact, according to the national survey, 34 per cent believe that the only side effect of juvenile arthritis is painful, achy joints. 

Gary Sage has seen first hand the impact juvenile arthritis can have on a young child. Ten years ago, his then five-year-old son, Geoff, was diagnosed with juvenile arthritis. Like many other Canadians, the Sage family was not aware that arthritis could affect people at such a young age. At first, they thought their son was having ‘growing pains’. However, after Geoff continued to complain about hurting bones and had difficulty sleeping, his family pursued the proper diagnosis. 

It took two months, many trips to the hospital and a series of tests before Geoff, who is now 15, was diagnosed with juvenile arthritis. Since his diagnosis, he has endured more than 200 hospital visits and is currently waiting to have his second hip-replacement surgery. 

“It’s really difficult to explain how this disease has impacted Geoff’s life because everything looks fine on the outside,” explains Gary. “Very few understand that arthritis can affect young people. The disease has taken away my son’s ability to live life like most 15-year-old kids. Geoff cannot ride a bike, play football or even put on his own socks most days. I am hopeful that one day, with commitment and dedication towards research and finding a cure, children with juvenile arthritis will be able to have access to the best treatments and will have a chance at experiencing remission.”

Though there are other Canadian families who are all too familiar with the struggles of juvenile arthritis, there remains a troubling gap in disease awareness and support. 

Click here for the complete media release