Arthritis
Arthritis is a very common condition in Australia, affecting people of all ages and from all walks of life. Its symptoms often have a big impact on people’s daily lives and it is the major cause of disability and chronic pain in Australia, with 3.85 million Australians affected. It costs our economy more than $23.9 billion each year in medical care and indirect costs such as loss of earnings and lost production.
As the population ages, the number of people with arthritis is growing. According to leading researcher Access Economics, current trends suggest that, by 2050, 7 million Australians will suffer from some form of arthritis.
There are a number of misconceptions about arthritis. There is a widely held belief that arthritis is simply a consequence of age, the pain of growing old. But it is not a natural part of ageing. In fact 2.4 million of all people suffering from the disease are of working age. It is commonly thought of as a single disease, when in fact it is an umbrella term for more than 100 medical conditions. Many of these conditions are autoimmune (where the body attacks itself) in origin, and involvement of other organs such as salivary & tear glands, lungs and kidneys is common. These patients are also at much higher risk for cardiovascular disease and some types of cancers. Further, many people believe that progressive joint deformity and disability are inevitable consequences of arthritis; when in fact there have been major treatment advances in recent years for some conditions such as Rheumatoid Arthritis.
Further treatment advances will depend on our increased understanding of the different disease processes, and this is the focus of our research. One way of approaching this is by studying different genes which may contribute to susceptibility. Other ways include identifying autoantibodies and other factors in the blood which may directly, or indirectly cause disease symptoms. We are also very active in evaluating new treatments in clinical trials. Some of the specific areas of our research follow.
This is the most common type of arthritis affecting our community. A NHMRC funded study, “FOSTAR”, is currently underway at TQEH, to evaluate the role of Omega 3 fatty acids (in the form of fish oil) in the relief of pain in patients with osteoarthritis of the knee. 400 osteoarthritis sufferers (200 at TQEH, in addition to patients at collaborating centres in Sydney and Hobart) have been allocated in a blinded fashion to receive a daily dose of either low or high dose fish oil for two years. Regular checks are performed to evaluate pain levels experienced in the knee in question, and the need for additional painkillers. Magnetic Resonance Imaging scans performed both before and after the treatment in a subgroup of patients, will determine whether or not fish oil is able to prevent deterioration of cartilage and bone over time in osteoarthritic joints. This study will be complemented in the laboratory by biochemical analysis of cartilage breakdown products in the bloodstream, as well as by determination of which genes may be important in predicting an individual’s response to receiving fish oil supplementation.
One per cent of the population suffer from this potentially crippling disease, which can present at any age. Surveys performed in Adelaide in the last decade have revealed that 50% of rheumatoid arthritis (RA) sufferers have to leave the workforce because of their disease within 10 years of diagnosis. Happily, with the benefit of international research into the mechanisms causing this disease, there are now many effective therapies for RA. The challenge is to obtain a correct diagnosis very early after disease onset, in order to effectively commence therapies which are proven to prevent joint damage, chronic pain and disability. In addition to the identification of genes which predict a more severe form of arthritis, TQEH Rheumatology Department has a large Rheumatology Clinical Trials Unit, which, along with two other Australian centres of excellence in Victoria and Queensland, is able to offer access to a broad range of effective treatments to patients who have not responded adequately to available therapies.