25 Years of Arthritis Research
Arthritis is a serious and misunderstood disease. For most people, it conjures images of a grandparent with aches, pains and stiffness. In reality, it isn’t even a single disease. The word “arthritis” describes over 100 medical conditions affecting the joints and people of all ages.
Imagine for a moment that you’re 19, and your fingers start hurting. Minor aches evolve into intense pain in other joints and extreme fatigue. You’re diagnosed with rheumatoid arthritis and have to drop out of university or stop working. Navigating your chronic illness becomes a full-time job. How will you support yourself if you can’t work or attend school?
Imagine you’re diagnosed with osteoarthritis. You have constant knee or hip pain, so you stop exercising. This puts you at risk for serious complications like heart disease. How do you know what exercise is safe? Where can you go for help?
Imagine you have a type of inflammatory arthritis, like lupus, and want to start a family, but you’re worried about the impact of your medications on a developing baby. Or, you know you will have to change your medications during pregnancy and are concerned that your symptoms will flare. What do you do?
While arthritis is often thought to be a disease that strikes later in life, it’s most often diagnosed between ages 30 and 45 when people are in the prime of their working lives and, for women, their childbearing years. It’s also on the rise. Over six million Canadians of all ages live with different types of arthritis and by 2040, that number is expected to increase by 50 per cent.
“Arthritis profoundly impacts every aspect of a person’s life, including their work, leisure, time with family and even how long they live,” said Dr. Diane Lacaille, Arthritis Research Canada’s Scientific Director. “Over the past 25 years, our scientists have led research to get people diagnosed earlier, receive better treatments and improve their quality of life.”
Answers in Research
Arthritis Research Canada was created in 1999 by Dr. John Esdaile, a world-renowned scientist and rheumatologist, to conduct practical research for everyday living – research to immediately touch and improve the lives of people with arthritis and address the challenges caused by severe and chronic illness.
“I was told that little could be done for people with arthritis,” said Dr. Esdaile, who led Arthritis Research Canada for over two decades as scientific director. “I thought I could help change that.” He started Arthritis Research Canada with just one other research scientist, Dr. Jacek Kopec, and one trainee, Dr. Lacaille, who succeeded him as scientific director.
Over the past 25 years, Arthritis Research Canada has grown into the largest clinical arthritis research organization in North America, with a team of more than 100 research scientists, trainees and staff located at centres in British Columbia, Alberta, Quebec and Nova Scotia. Scientists are affiliated with the University of British Columbia, Simon Fraser University, University of Calgary, Université Laval, McGill University, Université de Montréal and Dalhousie University and have expertise across arthritis-related disciplines.
“There’s no area that has had as much progress as arthritis has over the last 30 years, and it’s due to research,” said Dr. Esdaile. “I’m proud of the diverse team of scientists that we’ve built over the years. They, and our patient partners, have made a real difference in the lives of people with arthritis.”
Partnering with Patients for Life-Changing Results
Arthritis Research Canada’s scientists are preventing the devastating complications of arthritis like heart attacks, strokes and blood clots. They are improving mental health and creating tools to help people keep working, be physically active, make decisions about vaccines, safely start families, get high-quality sleep, and so much more.
However, none of these findings and tools would be possible without input from people living with arthritis. In 2002, Arthritis Research Canada formed the Arthritis Patient Advisory Board, which includes volunteer advocates with arthritis who bring personal experience and knowledge to every research project. In Quebec, the patient group is called Les Patients Intéressés par la Recherche sur l’Arthrite.
“The patient perspective is essential to our work at Arthritis Research Canada,” said Dr. Lacaille. “We want our research to result in practical tools and resources that help people living with arthritis today and in the future.”
The Making it WorkTM program is one example of a resource that resulted from research. Arthritis is a leading cause of work disability in Canada, costing the economy billions per year. For nearly two decades, Dr. Lacaille studied the connection between arthritis and employment and, along with a panel of experts and people with arthritis, developed Making it WorkTM. Not being able to work tremendously impacts a person’s financial, social and emotional well-being. The program focuses on early intervention to prevent work disability from arthritis and foster healthy, productive work lives.
“The ability to alter the lives of huge numbers of people can only happen through research. No research means no advances or improvements for people with arthritis,” said Dr. Esdaile. “If the final results of Making it WorkTM come in as we hope, the program will be able to reduce work disability for people with arthritis and impact everyone with inflammatory arthritis around the globe.”
When uncertainty strikes, Arthritis Research Canada and its patient partners conduct cutting-edge research for society’s most vulnerable people. During the COVID-19 pandemic, its scientists offered expert opinions to keep individuals living with arthritis safe as the virus evolved. British Columbia’s Ministry of Health made data available to Arthritis Research Canada, so scientists could respond quickly with some of the first research on COVID-19 complications in arthritis and vaccine efficacy and safety that informed public health policy.
When Canadian provinces started transitioning people from biologic originators to biosimilars, Arthritis Research Canada’s scientists and patient partners worked together to understand the impact of this change. The research results reassured people living with arthritis that biosimilars are just as safe and effective as originator biologics.
Arthritis Research Canada’s scientists were also the first to show that biologic drugs, the mainstay of treatment for inflammatory arthritis – like rheumatoid arthritis, vasculitis, and lupus – are safe in pregnancy.
“Before I started my training, I had the misconception that arthritis only affects older people,” said Dr. De Vera, Senior Scientist and Associate Director of Training at Arthritis Research Canada, who led the pregnancy and arthritis medications research. “Arthritis impacts people in their childbearing years, and it is such an understudied area of research. The impact is on women, babies and partners. These are important life decisions.”
Arthritis Research Canada was also the first to establish the impact of individual food items on gout. Dr. Natalie McCormick, a research trainee at Arthritis Research Canada and a post-doctoral fellow at Harvard, found that coffee decreased the risk of gout. At the same time, sugar-sweetened beverages, alcohol, meat and seafood increased the risk. Her research also showed that following a DASH-style or Mediterranean diet can reduce the risk of developing this type of arthritis.
Hip osteoarthritis is one of the most common joint diseases and is believed to be responsible for more than 75 per cent of hip replacements in Canada. Arthritis Research Canada’s Senior Scientist, Dr. Jolanda Cibere, and her team found that a common cause of hip arthritis is an anatomic lump of bone that damages cartilage. Determining the causes of hip pain can change treatments, reduce costly hip replacement surgeries, and improve the quality of life for Canadians at risk of this chronic disease.
Success Stories Hold Hope for Millions
Arthritis Research Canada’s partnership with patients extends beyond research. In 2019, Team Canada’s Spencer O’Brien became the organization’s spokesperson.
O’Brien was diagnosed with rheumatoid arthritis just a few months before competing at the 2014 Olympics in Sochi. At the time, the 25-year-old was one of the world’s top ranked snowboarders. She worried that her snowboarding career might be over.
“When they told me about my diagnosis, I didn’t think in a million years that I’d still get to be a professional snowboarder, but I went on to be one of the best in the world again,” O’Brien said. “I don’t think I’d be doing what I’m doing right now if it weren’t for arthritis research. It’s the dedication to the research and to improving treatment that allows me to live this life.”
As Arthritis Research Canada’s spokesperson, O’Brien hopes her journey dispels the myth that only older people get arthritis and inspires those with arthritis to know that, through arthritis research, they can find answers and get the help needed to get back on their feet and achieve a high quality of life.
“Arthritis Research Canada’s role is to transform the future for people like Spencer. We have to do more. We have to aim for a cure. We have to aim for prevention. And only research will make that happen,” said Dr. Esdaile.
A Strong Foundation for Future Research
The best way to ensure answers continue to be found for millions of Canadians living with arthritis, like O’Brien, is to help new scientists develop their careers. For this reason, Arthritis Research Canada has always prioritized training the next generation of researchers.
“The research that our trainees do is the research that we do. There is no separation,” said De Vera. “Trainees help drive the research at Arthritis Research Canada. They collect data, analyze it, write papers and present findings.”
Today, over 40 trainees call Arthritis Research Canada home and work across Canada and in various disciplines to help people living with different types of arthritis.
“We may not be able to cure arthritis right now, but we can certainly make a huge difference, said Dr. Lacaille. “The work that our scientists and trainees do is crucial.”
When Arthritis Research Canada started, people diagnosed with rheumatoid arthritis, on average, lived 20 years less than someone without rheumatoid arthritis. Thanks to research, that number has been reduced to three months.
“Arthritis Research Canada has accomplished a lot over the past 25 years, but there is still so much to do,” said Dr. Lacaille. “We will continue to find answers and develop programs to help people with arthritis thrive for many years to come.”
